血药浓度监测下伏立康唑致肝酶升高及视觉异常的药学监护

Pharmaceutical Care of a Patient with Elevated Liver Enzymes and Visual Abnormalities Induced by Voriconazole Under Blood Concentration Monitoring

目的探讨临床药师在伏立康唑用药过程中的药学监护作用。方法临床药师参与1例伏立康唑血药谷浓度在安全范围内的中年男性患者肝酶升高及视觉异常药品不良反应的治疗过程,充分利用其专业优势,查阅相关文献,分析导致肝酶升高及视觉异常的原因,给予处理措施建议,分析临床药师实施个体化药学监护的切入点。结果通过因果关系评价量表(RUCAM)评分分析,该患者出现肝酶升高及视觉异常为伏立康唑所致,医师调整用药剂量,患者病情得到有效控制。结论临床药师参与临床治疗,需密切关注用药安全,注意药物间的相互作用,有条件的医疗机构需进行血药浓度监测。

Objective To investigate the role of clinical pharmacists’participation in the pharmaceutical care of a patient treated with voriconazole.Methods Clinical pharmacists participated in the treatment of a middle-aged male patient with adverse drug reactions such as elevated liver enzymes and visual abnormalities,whose blood trough concentration of voriconazole was within the safe range.They made full use of their professional advantages and consulted relevant literature to analyze the causes of elevated liver enzymes and visual abnormalities and to make suggestions for treatment measures,and analyze entry points for clinical pharmacists to implement individualized pharmaceutical care.Results According to the analysis of Roussel Uclaf Causality Assessment Method(RUCAM),the patient’s elevated liver enzymes and visual abnormalities were induced by voriconazole.The doctor adjusted the dose,and the patient’s condition was effectively controlled.Conclusion When participating in the clinical treatment process,clinical pharmacists should pay close attention to drug safety and drug interactions,and the medical institutions where conditions permit should carry out blood drug concentration monitoring.