首页|1例疑似中药致CKD 5期患者急性高钾血症的药学监护

1例疑似中药致CKD 5期患者急性高钾血症的药学监护

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本文通过中药临床药师参与1例疑似中药致慢性肾脏病(CKD)5期患者急性高钾血症的药学监护,探索中药临床药师参与临床查房的思维模式和工作方式。本病例为CKD5期患者,因发现蛋白尿8年,间断双下肢水肿4年,复发加重1周入院。在中医科经规范、合理的抗血小板、调脂、护肾、改善贫血、降压、减轻心脏负荷、中药汤剂、中成药等药物对症支持治疗,病情好转,但住院期间血钾偏高,给予西医方法降血钾药物治疗后,血钾仍反复升高。为此,中药临床药师结合现有国内外文献协助临床医师查找引起血钾反复升高的因素,最终考虑中药引起的可能性较高,建议停用中药汤剂和中药注射剂,最终血钾恢复正常。中药引起的高钾血症在临床并不常见而往往被忽视,中药临床药师参与药学监护,结合其用药史及药物作用特点,协助医师查找和判断导致血钾升高的药物因素,并协助其制订和调整用药方案,保障患者用药安全。
Analysis of drug treatment of a suspected CKD 5 patient with acute hyperkalemia caused by traditional Chinese medicine
To explore the thinking and working mode of clinical pharmacists of traditional Chinese medicine participating in clinical,the drug treatment was analyzed by an acute hyperkalemia patient suspected of CKD 5 caused by traditional Chinese medicine.This case is a CKD 5 patient.Since proteinuria was found for 8 years,bilateral lower limb edema was intermittent for 4 years,and the recurrence was aggravated for 1 week,the patient was admitted to the hospital.In the Department of Traditional Chinese Medicine,the patient received standard and reasonable antiplatelet,lipid regulation,kidney protection,anemia improvement,blood pressure reduction,and heart load reduction,Traditional Chinese medicine decoction,traditional Chinese patent medicines.The patient's condition improved,but the newly emerging hyperkalemia prolonged the patient's hospital stay.After the treatment of blood potassium lowering drugs,the blood potassium still increased repeatedly.For this reason,clinical Chinese pharmacists assisted clinicians to find out the factors that caused the repeated increase of blood potassium in combination with existing domestic and foreign literature.Finally,considering the high possibility of traditional Chinese medicine,they stopped using traditional Chinese medicine and continued to use blood potassium lowering drugs,and the blood potassium returned to normal.Hyperkalemia caused by traditional Chinese medicine is not common in clinical practice and often is ignored.It can be seen that clinical pharmacists can participate in pharmaceutical care to find adverse drug reactions as soon as possible and ensure the safety of drug use.

Traditional Chinese medicineHyperkalemiaClinical pharmacistPharmacy monitoring

梁欢、郑涛、谢昭

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十堰市太和医院(湖北医药学院附属医院)药学部(湖北十堰 442000)

湖北医药学院药学院(湖北十堰 442000)

十堰市太和医院(湖北医药学院附属医院)中医科(湖北十堰 442000)

中药 高钾血症 中药临床药师 药学监护

国家自然科学基金青年基金湖北省自然科学基金湖北省自然科学基金湖北省卫生健康科研基金

817035822016CFB1532020CFB713WJ2019M057

2024

中国药师
国家药品监督管理局高级研修学院,武汉医药(集团)股份有限公司

中国药师

CSTPCD
影响因子:0.944
ISSN:1008-049X
年,卷(期):2024.27(1)
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