1例大剂量甲氨蝶呤延迟排泄致急性肾损伤患者救治的药学服务实践

A case report of pharmaceutical practice in treatment of acute kidney injury induced by delayed excretion of high-dose methotrexate

目的:通过临床药师参与救治1例大剂量甲氨蝶呤延迟排泄致急性肾损伤的患者,探讨临床药师参与药物治疗的药学服务模式与思路。方法:临床药师通过急性肾损伤相关药物的评价,探讨甲氨蝶呤延迟排泄的原因,提出个体化药学服务建议,协助医师制定有效的救治方案和监护计划。结果:在药师的参与下,患者救治成功,顺利出院。结论:对于大剂量甲氨蝶呤延迟排泄致急性肾损伤的患者,应密切监测药物浓度、剔除影响药物清除的不良因素并有效调整治疗方案;临床药师参与临床实践可以发挥积极作用。

Objective: To explore the mode and idea of pharmaceutical care provided by clinical pharmacists in drug treatment by analyzing the rescue of one case of acute renal injury caused by delayed excretion of high-dose methotrexate. Methods: Through evaluating drugs related with acute kidney injury and identifying reasons for delayed excretion of methotrexate, the clinical pharmacists proprosed individualized pharmaceutical care advice and provided assistance to physicians in developing timely and effective rescue programs and monitoring programs. Results: With the participation of pharmacists, the patient was rescued successfully and discharged smoothly.Conclusion: For acute renal injury caused by delayed excretion of high-dose methotrexate, the key measures include close drug concentration monitoring, eliminating the adverse factors affecting drug clearance, and adjusting the treatment effectively. Clinical pharmacists can play an active role in clinical practice.