1例中毒性表皮坏死松解症继发脓毒血症的药物治疗及监护

Pharmaceutical care of a case of toxic epidermal necrolysis secondary to sepsis

目的:探讨临床药师在中毒性表皮坏死松解症继发脓毒血症患者的治疗方案制定、治疗药物监测、皮肤护理、不良反应防治中的作用和价值。方法:临床药师通过ALEND评分识别可疑致敏药物为布洛芬,根据患者病原学检查结果,运用治疗药物监测协助临床医师优化抗感染治疗方案,同时对患者皮肤护理、药物不良反应等进行药学监护。结果:治疗后患者感染得到有效控制,临床症状好转,且未发生药物不良反应。结论:临床药师对患者实施全程药学监护,可优化治疗方案,及时发现和评估可能出现的严重药品不良反应,提高了药物治疗的安全性和有效性。

Objective:To explore the role and value of clinical pharmacists in the formulation and adjustment of treatment plans,drug monitoring,skin care and prevention of adverse reactions for toxic epidermal necrolysis secondary to sepsis.Methods:Clinical pharmacists identified ibuprofen as the suspected sensitizer by ALEND score,used therapeutic drug monitoring to assist clinicians to optimize the anti-infective treatment plan based on the results of etiological examination and the characteristics of PK/PD of antibiotics in burn patients and also conducted pharmaceutical care for patients’skin care,adverse drug reactions and so on.Results:Her infection was effectively controlled,clinical symptoms were improved,and no adverse drug reactions occurred after treatment.Conclusion:The whole-course pharmaceutical care provided by clinical pharmacists for patients with toxic epidermal necrolysis can optimize the treatment plan,timely detect and evaluate possible serious adverse drug reactions,and improve the safety and effectiveness of drug treatment.