1例系统性红斑狼疮合并耶氏肺孢子菌肺炎患者的药物治疗方案及药学监护探讨

Drug treatment regimens and pharmaceutical care for patients with systemic lupus erythematosus complicated with Pneumocystis jirovecii pneumonia

目的:探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)患者继发耶氏肺孢子菌肺炎(Pneumocystis jirovecii pneumonia,PJP)且对磺胺类药物过敏患者的药物治疗方案和药学监护。方法:临床药师参与1例SLE合并PJP且对磺胺类药物过敏患者的治疗,协助医师制定给药方案,从脱敏治疗、治疗药物监测(therapeutic drug monitoring,TDM)、剂量调整等方面进行药学监护。结果:患者经过脱敏治疗后,可接受甲氧苄啶-磺胺甲噁唑(trimethoprim-sulfamethoxazole,TMP-SMX)治疗,在治疗期间出现不良反应,通过TDM调整给药剂量,症状得到了有效控制。结论:临床药师对磺胺过敏患者行脱敏治疗,通过TDM提高了药物治疗的安全性和有效性。

Objective:To explore the drug treatment regimens and pharmaceutical care for patients with systemic lupus erythematosus(SLE) complicated with Pneumocystis jirovecii pneumonia(PJP) and an allergy to trimethoprim-sulfamethoxazole(TMP-SMX).Methods:Clinical pharmacists participated in the treatment of a patient with SLE complicated with PJP and history of sulfonamides allergy,assisted the doctor in formulating the drug administration plan,and performed pharmaceutical care in terms of desensitization treatment,therapeutic drug monitoring(TDM) and dose adjustment.Results:The patient could be treated with TMP-SMX after desensitization therapy and his symptoms were effectively controlled by adjusting the dosage via TDM.Conclusion:The safety and efficacy of drug treatment can be improved by TDM after clinical pharmacists perform desensitization therapy to the patient.