Analysis of Pharmaceutical Care in a Patient with Herpes Zoster Combined with Type 2 Diabetes and Depression
Objective:To analyze the pharmaceutical care process of drug therapy in a patient with herpes zoster combined with type 2 diabetes and depression,and provide reference for medication safety in patients with complex clinical medication conditions.Methods and Results:The patient was admitted to the hospital for treatment due to recent recurrent attacks of postherpetic neuralgia.The pains occurred 6-7 times every day,and the numerical rating scale(NRS)score of pains at admission was 3-5 points(8-10 points when aggravating).In addition,the patient had just been diagnosed with type 2 diabetes and depression;after treatment with first-line drugs such as tramadol,amitriptyline,pregabalin,and oxycodone successively for 10 days,the patient's postherpetic neuralgia was relieved obviously,with the NRS score of 2 points and no pain;the patient had multiple hypoglycemic reactions during the medication treatment.After reviewing relevant literature and combining the patient's condition and medication status,it was possibly related to pregabalin and tramadol;so it was recommended to clinically monitor the blood sugar and ask the patient to bring candy and other foods with him/her.On the 8th day of admission,scattered erythema,papules accompanied by itching appeared on the patient's right forearm,left wrist,and dorsums of feet,which was considered probably to be caused by oxycodone sustained-release tablets based on the medication time,and the patient quickly improved after discontinuing this drug.Moreover,during pharmaceutical care,the clinical pharmacist discovered that the analgesics such as tramadol,amitriptyline,and oxycodone and the antidepressant duloxetine used by the patient had the risk of causing serotonin syndrome.It is necessary to strengthen monitoring during combination medication to avoid the occurrence of adverse risks.Conclusion:Clinical pharmacists should observe the drug combination risks and adverse drug reactions when assisting in developing clinical drug treatment plans for patients with similar complex conditions,to ensure the therapeutic effect and medication safety of patients.
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