Practice of Clinical Pharmacists Participating in Drug Treatment for a Leukemia Child with Neutrophil De-ficiency Complicated with Fever
10.6039/j.issn.1001-0408.2017.35.29
- VernacularTitle:临床药师参与1例中性粒细胞缺乏伴发热白血病患儿的个体化药物治疗实践
- Author:
Dongmei DENG
1
;
Xue YANG
;
Cheng YANG
;
Wei WU
;
Jianhong CHEN
Author Information
1. 第三军医大学第三附属医院药剂科
- Keywords:
Clinical pharmacists;
Pharmaceutical care;
Bone marrow;
Neutrophil deficiency complicated with fever;
Leuke-mia;
Children
- From:
China Pharmacy
2017;28(35):4999-5003
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the role of clinical pharmacists in the process of drug treatment for leukemia children with neutrophil deficiency complicated with fever (NDCF). METHODS:Clinical pharmacists participated in the treatment for a leuke-mia child with NDCF. Considering about continuous decrease of platelet accompanied by epistaxis,combined with age,clinical symptom,lab indexes and related guidelines,clinical pharmacists thought it was possibly associated with bone marrow induced by chemotherapy drugs and drug-induced hemorrhage induced by cefoperazone sodium and sulbactam sodium. It was suggested to stop using cefoperazone sodium and sulbactam sodium;use Meropenem for injection 1.0 g,ivgtt,q8 h instead for anti-infection;addi-tionally use Recombinant human thrombopoietin injection 15000 U,sc,qd for elevating platelet. During treatment,taking into ac-count the low levels of neutrophils(0.17×109 L-1)and platelets(11×109 L-1)in this child,it was recommended to continue anti-in-fection and elevating platelet treatment,and continue to use Lienal polypeptide injection to auxiliarily enhance hematopoietic func-tion. When the child's condition was stable and neutrophils returned to normal,it was successively recommended to stop elevating platelet and anti-infection treatment;at the same time,conduct pharmaceutical care as body temperature examination,related indi-cator examination (such as routine blood test) and ADR monitoring,etc. RESULTS:Physicians adopted the clinical pharmacist's suggestions. The body temperature of the child was decreased,the hemogram recovered gradually,no infection occurred,and the next round of chemotherapy was successfully carried out. CONCLUSIONS:The clinical pharmacists participate in drug treatment for leukemia children with NDCF,pay attention to the prevention,diagnosis and treatment of drug-induced disease,and make com-prehensive analysis by using their own professional advantage,taking the possible effects of drugs on blood system,pharmacody-namics and pharmacokinetic characteristics as the breakthrough point,combing with the specific situation of children's age and ill-ness;assist physicians to formulate and optimize drug therapy plan so as to guarantee safe and effective drug use.
