1例两性霉素B治疗隐球菌性脑膜炎致低钾血症病例分析

Hypokalemia Induced by Amphotericin B in the Treatment of Cryptococcal Meningitis:A Case Report

目的 探讨两性霉素B治疗隐球菌性脑膜炎致低钾血症的相关因素和防治对策。方法 临床药师参与1例两性霉素B治疗隐球菌性脑膜炎致低钾血症患者治疗方案的调整,结合相关文献和指南分析出现低钾血症的原因,计算补钾治疗剂量,并调整治疗方案。结果 临床药师建议口服枸橼酸钾3.0 g(每天3次)后加用10%氯化钾注射液静脉补钾治疗,患者血清钾含量稳定,继续口服补钾治疗,抗真菌感染治疗有效,血清钾紊乱得到及时纠正,恢复正常。结论 临床药师从药学角度为低钾血症患者提供补钾方案,可辅助医师诊疗,提高疗效,减少药品不良反应。

Objective To investigate the related factors,prevention and treatment strategies of hypokalemia induced by amphotericin B in the treatment of cryptococcal meningitis.Methods The clinical pharmacists participated in the adjustment of the treatment scheme of a patient with hypokalemia induced by amphotericin B in the treatment of cryptococcal meningitis.They analyzed the causes of hypokalemia based on the relevant literature and guidelines,calculated the dosage of potassium supplementation,and adjusted the treatment scheme.Results The clinical pharmacists suggested adding 10%Potassium Chloride Injection intravenously for potassium supplementation after oral administration of 3.0 g potassium citrate(three times a day),then the patient'serum potassium content was stable,and he took orally potassium supplementation continuously.The antifungal infection treatment was effective,the disorder of serum potassium content was corrected in time,and the above index returned to the normal level.Conclusion Clinical pharmacists provide the potassium supplementation scheme for patients with hypokalemia from the perspective of pharmacy,which can assist physicians in diagnosis and treatment,improve the efficacy and reduce the incidence of adverse drug reactions.