注射用拉氧头孢钠致严重肝功能异常1例分析

One Case of Severe Liver Dysfunction Induced by Latamoxef Sodium for Injection

目的对1例注射用拉氧头孢钠致肝功能异常严重不良反应病例进行分析,为临床合理使用拉氧头孢钠提供参考。方法临床药师参与1例胆囊炎患者的药物治疗,通过筛查患者住院前后所用药物、诊疗经过查找肝损伤的原因,并采用药品不良反应(adverse drug reaction, ADR)关联性评价标准评估可能引起肝损伤的药物,最终确定导致肝功能异常的药物为注射用拉氧头孢钠,同时根据患者临床症状、实验室检查指标等先后建议加用谷胱甘肽保肝对症治疗;停用注射用拉氧头孢钠,改用头孢哌酮/舒巴坦钠抗感染治疗,并进行疗效评价、肝功能指标检测等药学监护。结果医师采纳临床药师建议;患者肝功能异常情况逐渐好转,腹部感染好转。结论在使用注射用拉氧头孢钠治疗过程中,医生应关注肝功能的变化,加强跟踪及用药监护,保证患者安全用药。

Objective To analyze one case of severe adverse reactions—liver damage caused by latamoxef sodium for injection in order to provide reference for rational use of latamoxef sodium. Methods A clinical pharmacist participated in the treatment of one patient with cholecystitis. The pharmacist screened the drugs used by this patient before and after hospitalization to find the cause of liver damage. The drugs that might have caused liver injury were evaluated by the relevance evaluation standard for adverse drug reactions(ADR).Finally, it was determined that the drug that caused abnormal liver function was latamoxef sodium for injection.According to the clinical symptoms and laboratory examination indexes of the patient, glutathione was added as a symptomatic therapy to protect the liver. Latamoxef sodium was replaced by efoperazone/sulbactam sodium as an anti-infection therapy, followed by efficacy evaluation of drugs and liver function index detection. Results Clinicians adopted the advice of the clinical pharmacist. The abnormal liver function and infection of the patient were gradually improved. Conclusion Clinicians ought to be alert to the changes of liver function when using latamoxef sodium for injection and do a better job of tracking and medication monitoring in order to ensure the safe use of drugs for patients.