临床药师参与1例造影剂脑病合并持续发热患者的药学实践

Clinical Pharmacist Involvement in Pharmacy Practice of a Patient with Contrast Encephalopathy Combined with Persistent Fever

目的:通过对1例使用碘克沙醇致造影剂脑病合并发热的临床病例进行分析,探讨临床药师参与患者诊疗过程中的作用,从药学角度协助医师识别药品不良反应,查找患者发热原因,优化临床用药方案,促进临床合理用药。方法:分析1例碘克沙醇导致造影剂脑病合并发热的病例资料,分析药物引起该不良反应的关联性判断,以及查找患者发热原因的诊疗经过。结果:通过药品不良反应关联性判定碘克沙醇引起造影剂脑病,给予激素抗炎、静脉输液水化、抗痛风等治疗,患者病情好转且未在发热。结论:造影剂脑病可表现短暂可逆性神经系统功能障碍,合并发热原因不明时,早期识别和鉴别很重要,可避免不恰当的治疗,临床药师应加强全程的药学监护,以促进临床合理用药,保证患者用药安全。

Objective: Through the analysis of a clinical case of contrast encephalopathy combined with fever caused by the use of iodixanol, to explore the role of clinical pharmacists to participate in the di-agnosis and treatment process of patients, to assist physicians in identifying adverse drug reactions from the pharmacological point of view, to find the causes of fever in patients, to optimize the clinical drug regimen, and to promote the rational use of clinical drugs. Methods: To analyze the data of a case of contrast encephalopathy combined with fever caused by iodixanol, to analyze the correlation judgment of the drug causing this adverse reaction, and to find the diagnosis and treatment of the cause of the patient’s fever. Results: Iodixanol was determined to cause contrast encephalopathy by adverse drug reaction association, and hormonal anti-inflammatory, intrave-nous fluid hydration, and anti-gout treatment were given, and the patient improved and was not in fever. Conclusion: Contrast encephalopathy can manifest transient reversible neurological dys-function, and when the cause of combined fever is unknown, early identification and differentiation are important to avoid inappropriate treatment, and clinical pharmacists should strengthen pharmacological monitoring throughout the process to promote rational clinical use and ensure patient medication safety.