再次暴露“乙胺吡嗪利福异烟片”致急性肾衰竭1例分析

目的分析1例55岁女性患者使用乙胺吡嗪利福异烟片(Ⅱ)出现急性肾衰竭不良反应的可能药物及其可能发生机制,总结国内外有关研究进展以供借鉴。方法临床药师通过查阅分析国内外有关文献,结合患者病情分析,明确导致患者出现不良反应的可能抗结核药物。结果引起患者出现急性肾衰竭不良反应的抗结核药物可能为间歇服用的“利福平”。结论使用乙胺吡嗪利福异烟片前,须明确病史病情及适应证,规范用药,尽量避免间歇服用。临床药师参与临床治疗能促进用药合理化,更加保证患者用药安全。

Acute Renal Failure Induced by Repeated Exposure to Ethambutol Hydrochloride,Pyrazinamide,Rifampicin and Isoniazid Tablets

Objective To analyze the causes of adverse reactions of acute renal failure in a 55-year-old female patient treated with ethambutol hydrochloride,pyrazinamide,rifampicin and isoniazid tablets(Ⅱ),and to summarize the experience and lessons learned at home and abroad.Methods By consulting the related literature and based on the patient's condition,clinical pharmacists identified the possible anti-tuberculosis drug that had induced acute renal failure in the patient.Results The adverse reactions of the patient with acute renal failure might have been due to the intermittent use of rifampicin.Conclusion Prior to treatment with ethambutol hydrochloride,pyrazinamide,rifampicin and isoniazid tablets,the medical history and indications of the patient should be clarified.Medication should be standardized and the intermittent use should be avoided as far as possible The participation of a clinical pharmacist in clinical treatment can help make medication more appropriate and ensure the safety of medication.