1例支气管舒张剂不耐受支气管哮喘患者的药学监护

Pharmaceutical care on a bronchodilator intolerance patient with bronchial asthma

1例74岁女性支气管哮喘急性发作患者,自述对氨茶碱过敏。入院后给予布地奈德、特布他林、异丙托溴铵舒张支气管、平喘、抗炎治疗,患者心悸不能耐受,加用糖皮质激素静脉滴注治疗后哮喘症状仍未明显缓解。临床药师协助医生分析患者对特布他林、异丙托溴铵心悸不能耐受的原因,并经仔细问诊排除氨茶碱过敏,调整治疗方案后哮喘症状得到控制,治疗25 d患者病情好转出院。此次治疗中,药师协助医生制定评估治疗方案,并在药物的超说明书用法、重复用药等方面给予药学监护。

One 74-year-old female patient with acute bronchial asthma, who narrated she was allergic to aminophylline, complained of palpitation after administration of budesonide, terbutaline and ipratropium bromide for diastole bronchus, relieving asthma, anti-infection therapy. The asthma symptom of the patient didn＇t improve even combination use of intravenous drip of glucoeorticoids. Clinical pharmacist assisted with physicians to analyze the cause of intolerance to terbutaline and ipratropium bromide and denied that the patient was allergic to aminophylline. The therapeutic schedules were adjusted, after 25-day therapy, asthma of the patient was controlled, and the patient was discharged. Clinical pharmacists played an important role in the pharmaceutical care on the evaluation of therapeutic regimen, usage of off-label, repeated drug use, etc.