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目的:分析头孢美唑与吡拉西坦联用致患者中枢神经系统反应的原因及其药学监护。方法:临床药师参与1例头孢美唑与吡拉西坦联用致患者中枢神经系统反应的药学监护,并分析了引起精神症状的原因。结果:临床使用头孢美唑为过量用药,头孢美唑中的7-唑环结构与戊四氮结构相似,而戊四氮是一惊厥药物,其神经毒性与亚胺培南相当,分析患者精神反应的表现与药物不良反应的症状,故考虑为肾功能衰竭患者由于头孢美唑过量用药与吡拉西坦联用引起的不良反应。结论:在临床治疗过程中常因忽视肾功能衰竭对药物代谢的影响而并发药物性脑病,尤其β-内酰胺类抗菌药物在肾功能衰竭患者中因剂量原因而诱发脑病的案例屡见不鲜,临床药师参与临床治疗配合医生制订治疗方案,使治疗过程少走了弯路,患者得到了治愈。
OBJECTIVE: To analyze the causes and pharmacological monitoring of central nervous system reactions in patients treated with cefmetazole and piracetam. METHODS: Clinical pharmacists participated in the pharmacogenetical monitoring of patients with central nervous system reaction with cefmetazole and piracetam, and analyzed the causes of the psychiatric symptoms. Results: The clinical use of cefmetazole overdose, cefmetazole 7-oxazole ring structure and pentylenetetrazol structural similarity, and pentylenetetrazol is a convulsive drug, its neurotoxicity and imipenem, analysis of the spirit of the patients Reaction and adverse drug reactions symptoms, it is considered as patients with renal failure due to excessive use of cefmetazole and piracetam in combination with adverse reactions. Conclusion: In the course of clinical treatment often overlooked the impact of renal failure on drug metabolism and concurrent drug-induced encephalopathy, especially β-lactam antibiotics in patients with renal failure due to dose-induced encephalopathy cases are common, clinical pharmacists involved Clinical treatment with the doctor to develop treatment options, so that the process of treatment less detours, patients have been cured.