1例使用头孢吡肟的肾功能不全患者的药学监护.pdfVIP

1 例使用头孢吡肟的肾功能不全患者的药学监护 1 2 1 1 王东晓 ，李莉 ，朱曼 （ 解放军总医院药品保障中心，北京 100853 ； 2甘肃省中医院药学部，甘肃兰州 730050 ） 摘要 目的 探讨头孢吡肟在肾功能不全患者中的应用注意。方法 通过对 1 例使用头孢吡肟抗感染治疗 的慢性肾功能不全患者的药学监护，探讨头孢吡肟神经毒性反应的相关危险因素、发生机制、防治措施等。 结果 头孢吡肟可引起神经系统毒性反应，与患者的年龄、肾功能、给药剂量等密切相关，其中肾功能是最 重要的危险因素，肾功能不全患者应及时调整给药剂量。如发生神经毒性反应要及时停药。结论 头孢吡肟 引起的中枢神经系统不良反应不容忽视。尤其对于合并肾功能不全的老年患者，应根据 Ccr 制定给药方案， 并进行全程的药学监护，保障患者的用药安全。 关键词 头孢吡肟；神经毒性；肾功能不全；剂量 Pharmaceutical care on a renal impairment patient treated with cefepime 1 2 1 1 WANG Dong-xiao , LI li , ZHU man ( Department of Pharmaceutical Care, PLA General Hospital, Beijing 2 Department of Pharmacy, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou ， 100853, China； 730050, China) Abstract Objective To explore the safety use of cefepime in patients with renal impairment. Methods The pharmaceutical care on an old pneumonia patient with renal failure who was treated with cefepime and developed neurotoxicity was analyzed to explore the risk factors, mechanism and treatment of cefepime-induced neurotoxicity. Results Approximately 85% of cefepime was excreted unchanged by kidneys. Among various risk factors (age, renal function, dosage, et al), cefepime-induced neurotoxicity was mainly related to renal function, necessitating dosage adjustment in patient with renal impairment. Treatment must be stopped immediately if cefepime-induced neurotoxicity occurred. Conclusion The neurotoxicity of cefepime cannot be underestimated, especially in old patients with renal impairment. The antibiotic regimen must be made by Ccr with the whole pharmaceutical care in the period of administration. KEYWORDS: cefepime; neurotoxicity; renal impairment; dose 随着抗菌药物的临床广