重度苯妥英钠中毒的药学监护

Pharmaceutical care of severe toxicosis of phenytoin sodium

目的首先确定中毒药物,然后通过测定血药浓度以了解中毒程度,为重度苯妥英钠中毒患者临床抢救治疗提供依据。方法间隔一定时间采集患者静脉血,萃取血中药物,在211 nm处以反相高效液相色谱法定性,明确中毒药物并测定血药浓度。结果在苯妥英中毒患者中最高血药浓度为68.94 mg.L-1,接近治疗浓度上限的3.5倍。结论患者为重度中毒,危及生命,需临床药师与临床医师积极配合,施行全程药学监护。

AIM To identify the poisonous pharmaceuticals, measure the blood concentration, evaluate the degree of toxicosis and provide evidences for clinical emergency treatment. METHODS The blood from the patient＇ s vein was collected at celtain interval, the pharmaceuticals from the plasma were extracted and determined by RP-HPLC at 211 nm, so as to identify the toxic medicatiom and measure the blood concentration. RESULTS The highest blood concen- tration of phenytoin sodium in the patient was 68.94 mg. L^- 1, about 3.5 times as large as the upper limit of the treatment concentration. CONCLUSION The patient is in severe toxicosis, which could lead to death. Pharmaceutical care demands to be delivered throughout the whole process of treatment under the joint efforts of clinical pharmaceutist and physicians, the patient was saved and discharged.