临床药师参与1例疑似亚胺培南/西司他丁致幻觉患者的药学监护

目的 探讨亚胺培南/西司他丁在急性胰腺炎患者使用后诱发幻觉的关联性评价、机制、影响因素、处理措施与药学监护.方法 1例重症急性胰腺炎患者发生幻觉时,临床药师及时分析和判断幻觉与亚胺培南/西司他丁的相关性,予以换用美罗培南及相关对症治疗.结果 经过治疗后患者神志清醒、幻觉逐渐消失.结论 对于存在肾功能不全、高龄等危险因素的患者,在应用亚胺培南/西司他丁时,应严密监测其精神状态.一旦出现幻觉及其他不适主诉,临床药师及临床医师应充分权衡利弊;如必须应用碳青霉烯类药物,可选择美罗培南以确保临床用药的安全性和有效性.

Pharmaceutical care of clinical pharmacist for one patient with hallucinations induced by suspected imipenem/cilastatin

Objective To investigate the relevance evaluation,mechanism,influential factors,measures and pharmaceutical care of hallucinations causing by imipenem/cilastatin in acute severe pancreatitis patients.Methods In the case of an severe acute pancreatitis patient with hallucinations,clinical pharmacists analyze and judge the association between hallucinations and imipenem/cilastatin timely,and recommend the use of meropenem and other symptomatic treatments.Results After treatment,the patient''s consciousness became clear and illusion gradually disappeared.Conclusion Patients with risk factors for renal insufficiency,aging,etc.should closely monitor the mental state when treated with imipenem/cilastatin. Once hallucinations and other discomfort have occurred,clinical pharmacists and clinicians must fully weigh the pros and cons. If it is necessary to use carbapenems,clinicians can choose meropenem to ensure the safety and efficacy of clinical medication.