Pharmaceutical care for a patient with paroxysmal spasms of extremities caused by ceftazidime-avibactam
OBJECTIVE To explore the role of clinical pharmacists in identifying paroxysmal spasms caused by drugs,and provide reference for rational drug use.METHODS Retrospective analysis was conducted on pharmaceutical care provided by clinical pharmacists for a patient with ceftazidime-avibactam(CZA-AVI)induced paroxysmal spasms.The clinical pharmacists identified,analyzed and summarized the clinical manifestations,risk factors and treatment methods of the nervous system toxicity caused by antibacterial drugs.According to the patient's clinical symptoms and test results,the clinical pharmacists recommended temporarily discontinuing the use of polymyxin B and montelukast sodium,and halving the dose of CZA-AVI.The physicians did not adopt the recommendation to halve the dose of CZA-AVI,and when the patient's neurologic toxicity did not improve,the clinical pharmacists again recommended discontinuing CZA-AVI,which was accepted by the physicians.RESULTS Clinical pharmacists analyzed the condition and checked related drugs that caused paroxysmal spasms of extremities one by one,and finally determined that CZA-AVI might be the drug that caused paroxysmal spasms of extremities in the patient.After stopping the drug,the patient's symptoms improved and was transferred to a community hospital for rehabilitation treatment.CONCLUSIONS The dose of CZA-AVI should be adjusted according to the renal function and the neurotoxicity should be guarded against,especially for patients with advanced age,renal insufficiency,and the combined use of multiple drugs related to nephrotoxicity and neurotoxicity.
ceftazidime-avibactamparoxysmal spasms of extremitiesadverse drug reactionspharmaceutical carenervous system toxicity
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