临床药师对卡马西平中毒患儿解救用药的分析与监护

Analysis and Monitoring of Clinical Pharmacists' Rescue Medication for Children with Carbamazepine Poisoning

目的:探讨使用卡马西平出现中毒反应的解救措施及其血药浓度监测对患儿的应用价值。方法:临床药师分析和评价临床1例卡马西平误服中毒患儿的病例,应用免疫荧光法检测患儿血药浓度,监测患儿血药浓度变化。结果:临床药师针对患儿的具体情况,查阅文献,分析卡马西平与奥美拉唑的相互作用机制。奥美拉唑与卡马西平联合应用时,奥美拉唑可导致卡马西平蓄积,影响中毒解救。同时,血药浓度监测在中毒解救过程中可发挥重要作用。结论:卡马西平中毒患儿不宜使用奥美拉唑;密切监测患儿的血药浓度,对提高卡马西平中毒患儿的抢救成功率具有重要意义。

OBJECTIVE： To investigate the countermeasures of carbamazepine poisoning reaction and the application value of blood drug concentration detection in children. METHODS： The clinical pharmacists analyzed and evaluated one child with carbamazepine intoxication. The blood concentration of the child was detected by immunofluorescence,and the blood drug concentration of the child was monitored. RESULTS： The clinical pharmacists consulted the literature on the specific conditions of the child and analyzed the interaction mechanism between carbamazepine and omeprazole. When omeprazole was combined with carbamazepine,omeprazole could lead to the accumulation of carbamazepine and affect the rescue of poisoning. In the meantime,blood concentration monitoring played an important role in the process of poisoning rescue. CONCLUSIONS： Omeprazole should not coadministered in children with carbamazepine poisoning; and closely monitoring on the blood concentration of children is of great significance in improving the success rate.