1例甲氨蝶呤联合地塞米松鞘内注射治疗神经精神性狼疮的用药分析

Intrathecal injection with methotrexate and dexamethasone for one case of neuropsychiatric systemic lupus erythematosus

临床药师参与了1例神经精神性狼疮患者药物治疗方案的制定,分析了患者癫痫症状复发原因,通过查阅文献对神经精神性狼疮治疗方案及甲氨蝶呤联合地塞米松鞘内注射的治疗疗效和不良反应进行汇总梳理,建议治疗组选用甲氨蝶呤联合地塞米松鞘内注射的替代治疗方案并进行相关用药监护。患者鞘内注射甲氨蝶呤及地塞米松后,无严重不良反应,未再发癫痫,病情好转出院。临床药师参与医疗团队,协助治疗组制定药物治疗方案,并进行药物监护,对临床合理用药起到了一定作用。

Clinical pharmacists participated in the treatment of 1 patient with neuropsychiatric lupus erythematosus, and analyzed the cause of epilepsy recurrence. We summarized the treatment of neuropsychiatric lupus and the efficacy and adverse reaction of intrathecal injection with methotrexate and dexamethasone through literature review, and recommended intrathecal injection with methotrexate and dexamethasone as an alternative treatment, with pharmaceutical care. After the intrathecal injection of methotrexate and dexamethasone, the patient was improved and discharged without adverse reaction and epilepsy recurrence. By cooperating with physicians to optimize treatment and offer pharmaceutical care, clinical pharmacists play an important role in clinical rational drug use.