Pharmaceutical practice of clinical pharmacist participation in a patient with Epstein-Barr virus encephalitis

WANG Yan; ZHU Shaohui; YANG Jianing; CHEN Xiaoshan; ZHOU Minhua

doi:10.6039/j.issn.1001-0408.2023.24.19

您当前的位置：

首页 >

文章列表页 >

Pharmaceutical practice of clinical pharmacist participation in a patient with Epstein-Barr virus encephalitis

更新时间：2025-09-23

- Pharmaceutical practice of clinical pharmacist participation in a patient with Epstein-Barr virus encephalitis
- ZHONGGUO YAOFANG Vol. 34, Issue 24, Pages: 3060-3063(2023)
- 作者机构：
  
  广东省中西医结合医院药学部，广东佛山　528200
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.24.19
  CLC： R969.3
- Received：16 April 2023，
  
  Revised：2023-10-27，
  
  Accepted：03 November 2023，
  
  Published：30 December 2023
- 稿件说明：
移动端阅览
王艳,朱少惠,杨佳宁,等.临床药师参与1例EB病毒性脑炎患者的药学实践 [J].中国药房,2023,34(24):3060-3063.

WANG Yan,ZHU Shaohui,YANG Jianing,et al.Pharmaceutical practice of clinical pharmacist participation in a patient with Epstein-Barr virus encephalitis[J].ZHONGGUO YAOFANG,2023,34(24):3060-3063.
王艳,朱少惠,杨佳宁,等.临床药师参与1例EB病毒性脑炎患者的药学实践 [J].中国药房,2023,34(24):3060-3063. DOI： 10.6039/j.issn.1001-0408.2023.24.19.

WANG Yan,ZHU Shaohui,YANG Jianing,et al.Pharmaceutical practice of clinical pharmacist participation in a patient with Epstein-Barr virus encephalitis[J].ZHONGGUO YAOFANG,2023,34(24):3060-3063. DOI： 10.6039/j.issn.1001-0408.2023.24.19.

摘要

目的

探讨临床药师在EB（Epstein-Barr）病毒性脑炎患者治疗过程中的作用。

方法

临床药师参与1例EB病毒性脑炎患者的诊疗过程。临床药师针对患者疾病生理特点及所用抗菌药物的药代动力学特性，建议将头孢曲松的剂量调整为2 g，q12 h，美罗培南调整为2 g，q8 h；针对感染未控制，建议停用头孢曲松，更改为万古霉素100万U，q12 h；根据病原学结果，建议停用阿昔洛韦，更改为更昔洛韦5 mg/kg，q12 h；针对电解质紊乱，考虑可能为甘露醇注射液导致的不良反应，建议停用该药。

结果

临床医师采纳了临床药师的建议。经治疗，患者好转，准予出院。

结论

临床药师通过参与EB病毒性脑炎患者的药学监护，协助医师优化了治疗方案，保证了患者用药的有效性和安全性。

Abstract

OBJECTIVE

To investigate the role of clinical pharmacists in the treatment of a patient with Epstein-Barr （EB） virus encephalitis.

METHODS

Clinical pharmacist participated in drug diagnosis and therapy for a patient with EB virus encephalitis. According to the physiological characteristics of the disease and the pharmacokinetic-pharmacodynamic characteristics of antibiotics， clinical pharmacists suggested that the dose should be adjusted as ceftriaxone 2 g， q12 h+meropenem 2 g， q8 h. Based on the uncontrolled infection of the patient， pharmacists suggested that ceftriaxone should be stopped and vancomycin 1 million U and q12 h should be used as alternative therapy. According to the results of etiology， pharmacists suggested that acyclovir should be discontinued and replaced with ganciclovir 5 mg/kg， q12 h. The electrolyte disturbance of the patient may be adverse drug reactions caused by Mannitol injection， it was recommended to stop the drug.

RESULTS

The clinician followed the advice of the clinical pharmacists. After treatment， the patient improved and was discharged.

CONCLUSIONS

Clinical pharmacists can carry out pharmaceutical care for patients with EB virus encephalitis， assist physicians in optimizing the treatment plan of patients， and ensure the effectiveness and safety of drug treatment.

关键词

Keywords

references

GBD Meningitis Collaborators . Global，regional，and national burden of meningitis，1990-2016：a systematic analysis for the Global Burden of Disease Study 2016 [J ] . Lancet Neurol ， 2018 ， 17 （ 12 ）： 1061 - 1082 .

魁学梅，彭小兰，严雯，等 . 1例病毒性脑炎并发癫痫持续状态患者的药学监护实践 [J ] . 药物流行病学杂志， 2016 ， 25 （ 11 ）： 722 - 724 .

KUI X M ， PENG X L ， YAN W ， et al . Pharmaceutical care on a patient with viral encephalitis accompanied by status epilepticus [J ] . Chin J Pharmacoepidemiol ， 2016 ， 25 （ 11 ）： 722 - 724 .

KASPER D L ， FAUCI A S . 哈里森感染病学 [M ] . 上海：上海科学技术出版社， 2019 ： 304 - 307 .

KASPER D L ， FAUCI A S . Harrison’s TM infectious di-seases [M ] . Shanghai ： Shanghai Science and Technology Press ， 2019 ： 304 - 307 .

关鸿志 . 病毒性脑炎的诊治 [J ] . 中华神经科杂志， 2022 ， 55 （ 7 ）： 747 - 754 .

GUAN H Z . Diagnosis and treatment of viral encephalitis [J ] . Chin J Neurol ， 2022 ， 55 （ 7 ）： 747 - 754 .

TUNKEL A R ， GLASER C A ， BLOCH K C ， et al . The management of encephalitis：clinical practice guidelines by the Infectious Diseases Society of America [J ] . Clin Infect Dis ， 2008 ， 47 （ 3 ）： 303 - 327 .

国家卫生计生委医政医管局，国家卫生计生委合理用药专家委员会 . 国家抗微生物治疗指南：第2版 [M ] . 北京：人民卫生出版社， 2017 ： 78 - 79 .

National Health and Family Planning Commission Medical Administration ， National Health and Family Planning Commission rational drug use expert member . National guidelines for antimicrobial therapy： 2nd Ed [M ] . Beijing ： People’s Medical Publishing House ， 2017 ： 78 - 79 .

中国医药教育协会感染疾病专业委员会 . 抗菌药物药代动力学/药效学理论临床应用专家共识 [J ] . 中华结核和呼吸杂志， 2018 ， 41 （ 6 ）： 409 - 446 .

Infectious Diseases Committee of Chinese Medical Education Association . Expert consensus on the clinical application of antimicrobial pharmacokinetics/pharmacodyna-mics theory [J ] . Chin J Tub Resp ， 2018 ， 41 （ 6 ）： 409 - 446 .

傅绍军，朱利民，洪枫 . 抗巨细胞病毒药物：更昔洛韦 [J ] . 国外医药（抗生素分册）， 2004 ， 25 （ 6 ）： 282 - 286 .

FU S J ， ZHU L M ， HONG F . Anti-cytomegalovirus drug：ganciclovir [J ] . World Notes Antibiot ， 2004 ， 25 （ 6 ）： 282 - 286 .

黄永 . 更昔洛韦与阿昔洛韦体外抗水痘-带状疱疹病毒活性的研究 [D ] . 天津：天津医科大学， 2005 .

HUANG Y . Research of antiviral activity of ganciclovir and acyclovir to varicella-zoster virus in vitro [D ] . Tianjin ： Tianjin Medical University ， 2005 .

中华医学会神经外科学分会小儿学组，中华医学会神经外科学分会神经重症协作组，《甘露醇治疗颅内压增高中国专家共识》编写委员会 . 甘露醇治疗颅内压增高中国专家共识 [J ] . 中华医学杂志， 2019 ， 99 （ 23 ）： 1763 - 1766 .

Pediatric Group ， Neurosurgery Society of Chinese Medical Association ， Neurological Intensive Care Collaborative Group ， Neurosurgery Branch ， Chinese Medical Association ， The Writing Committee of the Chinese Expert Consensus on the Treatment of Elevated Intracranial Pressure with Mannitol . Chinese expert consensus on the treatment of intracranial hypertension with mannitol [J ] . Chi Med J ， 2019 ， 99 （ 23 ）： 1763 - 1766 .

国家药典委员会 . 中华人民共和国药典临床用药须知：化学药和生物制品卷：2015年版 [M ] . 北京：中国医药科技出版社， 2017 ： 434 - 435 .

National Pharmacopoeia Commission . Pharmacopoeia of the People’s Republic of China Clinical Drug Instructions：chemical drugs and biological products volume：2015 edition [M ] . Beijing ： China Medical Science and Techno-logy Press ， 2017 ： 434 - 435 .

国家食品药品监督管理局药品安全监管司，国家药品不良反应中心 . 药品不良反应报告和监测工作手册 [R ] . 2005 ： 46 .

State Food and Drug Administration Drug Safety Supervision Department，National Adverse Drug Reaction Center . Adverse drug reaction reporting and monitoring workbook [R ] . 2005 ： 46 .

Views

252

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Individualized treatment and pharmaceutical care for breast cancer complicated with chronic kidney disease

Anticoagulation therapy analysis and pharmaceutical care for a breast cancer patient with pulmonary thromboembolism accompanied by multiple comorbidities

Antithrombotic therapy and pharmaceutical care of a child with purpura nephritis complicated with lower extremity deep venous thrombosis

Pharmaceutical care for a patient with diabetes complicated with suspected hyperlipidemia induced by immunosuppressive agents after liver transplantation

Pharmacy practice of clinical pharmacists involved in the treatment of a case of bullous pemphigoid and pulmonary aspergillosis combined with disseminated Nocardia farcinica infection

Related Author

ZHANG Ming

YU Lu

WU Xudong

HUO Meng

CHENG Qijian

LIN Jiayuan

LIU Weiting

LI Boxia

Related Institution

Dept. of Internal Medicine， Zhonggongmiao Community Hospital of Ningbo Yinzhou District No.2 Hospital Medical Community

Dept. of Clinical Pharmacy， Ningbo Yinzhou District No.2 Hospital

Dept. of Pulmonary & Critical Care Medicine， Ruijin Hospital， Shanghai Jiao Tong University School of Medicine

Dept. of Pharmacy， Ruijin Hospital， Shanghai Jiao Tong University School of Medicine

Dept. of Pharmacy， the First Affiliated Hospital of Wenzhou Medical University

⁰