老年患者因反复咳喘再加重药物治疗致谵妄的病例1例分析

Analysis of a case of delirium caused by repeated cough and asthma and aggravated drug treatment in an elderly patient

1例80岁老年男性患者因反复咳喘7年,再发加重2天入院,临床治疗过程中出现谵妄。临床药师通过查阅大量文献,从给药时间、给药剂量、药物相互作用、停药后患者症状和体征变化等方面,逐层分析各药物导致神经系统损害的可能性。发现该患者出现谵妄,关联性评价为“肯定”的药物是莫西沙星和头孢吡肟;关联性评价为“可能”的药物是多索茶碱、氨溴索、复方甲氧那明胶囊。因此在临床实践中,临床药师可以通过对药物治疗事件的分析与监护,发挥指导安全合理用药的作用。

An 80-year-old male patient with repeated cough and asthma for 7 years was admitted to the hospital for 2 days due to further aggravation,which resulted in delirium during clinical treatment.By consulting a large number of pieces of literature,clinical pharmacists analyzed the possibility of nervous system damage caused by each drug layer by layer from the aspects of administration time,administration dose,drug interaction,changes of symptoms and signs of patients after drug withdrawal,etc.It was found that the patient had delirium.And the drugs evaluated as"positive"were moxifloxacin and cefepime.The drugs evaluated as"possible"were doxofylline,ambroxol and compound methoxyphenamine capsules.Therefore,in clinical practice,clinical pharmacists can play the role in safe and rational medication by analyzing and monitoring drug treatment events.