临床药师参与1例淋巴结核患者个体化给药的治疗实践

Pharmaceutical practice of clinical pharmacists in the individualized drug therapy of a patient with lymphatic tuberculosis

1例61岁女性淋巴结核患者,服用利福平与莫西沙星抗结核治疗1个月,疗效欠佳。该患者有精神分裂症史20余年,1年前因肾功能衰竭,规律血透治疗至今。临床药师建议调整个体化抗结核方案为利福平(0.45 g,qd,po)+乙胺丁醇(0.75 g,qod,po)+吡嗪酰胺(1.5 g,biw,po),医生采纳;同时临床药师对患者进行用药教育,嘱患者定期监测肝功能、血常规等。患者规律服药,5个月后随访,影像学提示纵膈淋巴结较前好转,无相关不良反应发生。目前患者继续规律用药,情况良好。

A 61-year-old female patient with lymphatic tuberculosis was treated with rifampicin and moxifloxacin for one month, but the curative effect was limited. She had schizophrenia for more than 20 years, and has been treated with regular hemodialysis until now due to renal failure which happened one year ago. Clinical pharmacists suggested giving her an individual anti-tuberculosis regimen including rifampicin(0.45 g, qd, po), ethambutol(0.75 g, qod, po) and pyrazinamide(1.5 g, biw, po),which was adopted by the doctor. At the same time, the clinical pharmacists provided medication education to her, including regular monitoring of liver function and blood routine, etc. The patient took drugs regularly. Five months later, the imaging test showed that the mediastinal lymph nodes were better than before, and no adverse reaction occurred. At present, the patient continues to take drugs regularly and keeps in good condition.