摘要
目的为多发性骨髓瘤合并慢性肾脏病病人治疗过程中突发癫痫寻找原因,尽量避免由于药物蓄积和药物不合理联用导致不良反应的发生。方法报告多发性骨髓瘤合并肾衰竭治疗诱发癫痫1例。通过查阅药品说明书和文献,结合病人自身疾病和临床用药,分析发生癫痫原因,并开展药学监护。结果该例病人治疗过程中突发癫痫,是由于长时间使用头孢哌酮钠他唑巴坦钠,导致药物在体内蓄积引起。同时,美罗培南可使丙戊酸钠血药浓度降低,引起癫痫再次发作。结论慢性肾脏病病人药物治疗过程中,由于肾脏排泄功能障碍,容易导致药物在体内蓄积,可能引发药物不良反应,要根据病人内生肌酐清除率调整药物用量;临床在使用丙戊酸钠抗癫痫时,尽量避免使用美罗培南等碳青霉烯类药物。
Objective To look for the cause of sudden epilepsy in the treatment of chronic kidney disease,and to avoid the adverse reactions caused by the drug accumulation and the irrational combination of drugs.Methods By consulting drug instructions and literature,combined with patients’own diseases and clinical medication,the causes of epilepsy were analyzed,and pharmaceutical care were carried out.Results The convulsion in the course of treatment was caused by the long⁃term use of cefoperazone sodium and tazobactam sodium,resulting in the accumulation of drugs in the body.At the same time,meropenem can reduce the plasma concentration of valproate and cause seizure recurrence.Conclusions In the drug treatment for patients with chronic kidney dis⁃ease,due to renal excretion dysfunction,it is easy to cause drug to accumulate in the body,possibly lead to adverse drug reactions.The drug dosage should be adjust according to the patient’s endogenous creatinine clearance rate.In the clinical use of sodium val⁃proate anti epileptic,the use of meropenem and other carbapenem Alkenes should be avoid.
作者
耿魁魁
史天陆
张圣雨
苏丹
沈爱宗
GENG Kuikui;SHI Tianlu;ZHANG Shengyu;SU Dan;SHEN Aizong(Department of Pharmacy,The First Affiliated Hospital of USTC,University of Science and Technology of China(Anhui Provincal Hospital),Hefei,Anhui 230001,China)
出处
《安徽医药》
CAS
2020年第1期193-196,共4页
Anhui Medical and Pharmaceutical Journal
关键词
多发性骨髓瘤
肾功能不全
癫痫
头孢哌酮
药学服务
药物毒性
他唑巴坦
丙戊酸
美罗培南
药物蓄积
Multiple myeloma
Renal insufficiency
Epilepsy
Cefoperazone
Pharmaceutical services
Drug toxicity
Tazonactam
Valproic acid
Meropenem
Drug accumulation
