1例临床药师参与美罗培南联用丙戊酸钠的临床实践

One Case of Clinical Pharmacists Participating in the Clinical Practice of Meropenem Combined with Valproic Acid

目的总结临床药师参与1例颅脑术后患者美罗培南联用丙戊酸钠的临床实践,为患者合理用药提供参考建议。方法临床药师通过分析1例颅脑术后美罗培南联用丙戊酸钠引起丙戊酸钠血药浓度明显下降的案例,提出血药浓度监测和给药方案建议,并通过文献复习为后续相似的案例提供用药参考。结果与结论碳青霉烯类药物联用丙戊酸钠可导致丙戊酸钠血药浓度明显下降,临床可通过调整抗癫痫药物、抗感染药物或加强患者的监测,取得良好的治疗效果。

OBJECTIVE To provide rational medication reference advice for patients by summaring the clinical practice of clinical pharmacists participating in a case of meropenem combined with valproic acid after craniocerebral operation. METHODS Clinical pharmacists analyzed the case in which there was a combination of meropenem and valproic acid after craniocerebral operation that led to decrease the serum concentration of valproic acid significantly, and proposed the serum concentration monitoring and medication suggestion, then provided medication reference for similar cases as follows through literatures review. RESULTS CONCLUSION The combination of carbapenems and valproic acid may lead to decrease the serum concentration of valproic acid significantly, clinical pharmacists advised to adjust antiepileptic drugs, anti-infective drugs or strengthen monitoring patients in clinical to obtain the good treatment effect.