1例甲氨蝶呤片严重中毒患者的药学监护

Pharmaceutical care of a severely poisoned patient with methotrexate tablets

目的探讨甲氨蝶呤片严重中毒患者的有效药物治疗方案。方法临床药师参与1例甲氨蝶呤片严重中毒患者的治疗过程,通过分析抗菌药物常见不良反应及药动学特点,结合细菌培养及相关检查指标,及时调整抗菌治疗方案;结合患者个体因素,尽早应用骨髓抑制解毒方案;结合患者凝血功能、生化指标及相关药物药理特性,针对性地选择合适的止血、抑酸、补液治疗方案。结果患者住院治疗后脱离生命危险,总体转归情况良好,顺利出院。结论临床药师在临床治疗中充分运用药学知识,协助医师调整用药方案,提高临床药物治疗水平。

Objective To explore the effective medication plan for a patient with severe methotrexate poisoning.Methods Clinical pharmacists participated in the treatment of a patient with severe methotrexate poisoning.By analyzing the common adverse reactions and pharmacokinetic characteristics of antibiotics and based on bacterial culture and related examination indexes,clinical pharmacists recommended quickly adjusting the antibacterial treatment plan.Given the individual factors of the patient,clinical pharmacists advised the clinicians to adopt the bone marrow suppression detoxification scheme as soon as possible.According to the coagulation function,biochemical indexes and pharmacological characteristics of related drugs,the clinical pharmacists gave tips on ways of appropriate hemostasis,acid suppression,and fluid replacement.Results After hospitalization,the patient was out of danger,the overall outcome was good,and she was discharged.Conclusion Clinical pharmacists can assist clinicians in adjusting the drug regimen and improve the level of clinical medication by making full use of their knowledge of pharmaceuticals.