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应中央军委要求,2022年9月起,《药学实践杂志》将更名为《药学实践与服务》,双月刊,正文96页;2023年1月起,拟出版月刊,正文64页,数据库收录情况与原《药学实践杂志》相同。欢迎作者踊跃投稿!

肾功能亢进患者应用万古霉素致急性肾损伤的用药监护

陆灏迪 唐莲 方洁 薛盛敏 尚尔宁 薛苏冬

陆灏迪, 唐莲, 方洁, 薛盛敏, 尚尔宁, 薛苏冬. 肾功能亢进患者应用万古霉素致急性肾损伤的用药监护[J]. 药学实践与服务, 2019, 37(3): 274-278. doi: 10.3969/j.issn.1006-0111.2019.03.017
引用本文: 陆灏迪, 唐莲, 方洁, 薛盛敏, 尚尔宁, 薛苏冬. 肾功能亢进患者应用万古霉素致急性肾损伤的用药监护[J]. 药学实践与服务, 2019, 37(3): 274-278. doi: 10.3969/j.issn.1006-0111.2019.03.017
LU Haodi, TANG Lian, FANG Jie, XUE Shengmin, SHANG Erning, XUE Sudong. Drug monitoring of acute kidney injury induced by vancomycin in patients with augmented renal clearance[J]. Journal of Pharmaceutical Practice and Service, 2019, 37(3): 274-278. doi: 10.3969/j.issn.1006-0111.2019.03.017
Citation: LU Haodi, TANG Lian, FANG Jie, XUE Shengmin, SHANG Erning, XUE Sudong. Drug monitoring of acute kidney injury induced by vancomycin in patients with augmented renal clearance[J]. Journal of Pharmaceutical Practice and Service, 2019, 37(3): 274-278. doi: 10.3969/j.issn.1006-0111.2019.03.017

肾功能亢进患者应用万古霉素致急性肾损伤的用药监护

doi: 10.3969/j.issn.1006-0111.2019.03.017
基金项目: 江苏省苏州市科技发展计划项目(SYSD2016152);江苏省药学会医院药学基金项目(A201613)

Drug monitoring of acute kidney injury induced by vancomycin in patients with augmented renal clearance

  • 摘要: 目的 探讨肾功能亢进患者万古霉素个体化用药中出现急性肾损伤的原因。 方法 对南京医科大学附属苏州医院使用万古霉素且发生急性肾损伤的3个病例进行药学监护,分析使用群体药动学软件预测万古霉素谷浓度准确性差的原因,寻找发生万古霉素急性肾损伤的原因。 结果 在查明患者发生不良反应的原因后,对其进行针对性治疗,均获得较好的控制与转归。 结论 肾功能亢进患者出现万古霉素相关性肾损害主要为联用肾毒性药物、肾脏灌注不足,临床用药中需加强用药监护,提高万古霉素用药安全性。
  • [1] MAHMOUD S H,SHEN C.Augmentedrenal clearance in critical illness:An important consideration in drug dosing[J].Pharmaceutics,2017,9(3):E36.
    [2] BILBAO-MESEGUER I,RODRÍGUEZ-GASCÓN A,BARRASA H,et al. Augmented renal clearance in critically ill patients:a systematic review[J].Clin Pharmacokinet,2018,57(9):1107-1121.
    [3] BAMGBOLA O.Review of vancomycin-induced renal toxicity:an update[J].Ther Adv Endocrinol Metab,2016,7(3):136-147.
    [4] 何娟,杨婉花.基于群体药动学的万古霉素个体化给药模式的建立和临床应用[J].中国临床药学杂志,2015,24(1):27-31.
    [5] 汤月秋,杨立川.心脏术后并发急性肾损伤的危险因素分析[J].实用医院临床杂志,2018,15(6):68-71.
    [6] 钟少榕,滕杰.心脏手术围术期血压管理与急性肾损伤[J].中华肾脏病杂志,2018,34(3):232-235.
    [7] 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.
    [8] EIDELSON A,MULDER B,KARCUTSKIE A,et al. 81augmented creatinine clearance in severely injured burn patients[J].J Burn Care Res,2018,39(suppl_1):S45-S46.
    [9] 陆灏迪,唐莲,薛盛敏,等.万古霉素群体药代动力学在肾功能亢进患者中的临床验证[J].中华危重病急救医学,2018,30(5):444-448.
    [10] 万古霉素临床应用剂量专家组.万古霉素临床应用中国专家共识(2011版)[J].中国新药与临床杂志,2011,30(8):561-573.
    [11] BRUSSELAERS N,MONSTREY S,COLPAERT K,et al. Outcome of acute kidney injury in severe burns:a systematic review and meta-analysis[J].Intensive Care Med,2010,36(6):915-925.
    [12] HIDAYAT L K,HSU D I,QUIST R,et al. High-dose vancomycin therapy for methicillin-resistant Staphylococcus aureus infections:efficacy and toxicity[J].Arch Intern Med,2006,166(19):2138-2144.
    [13] LIU C,BAYER A,COSGROVE S E,et al. Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children[J].Clin Infect Dis,2011,52(3):e18-e55.
    [14] SIME F B,UDY A A,ROBERTS J A.Augmented renal clearance in critically ill patients:etiology,definition and implications for beta-lactam dose optimization[J].Curr Opin Pharmacol,2015,24:1-6.
    [15] CHU Y,LUO Y F,QU L Y,et al. Application of vancomycin in patients with varying renal function,especially those with augmented renal clearance[J].Pharm Biol,2016,54(12):2802-2806.
    [16] 唐莲,陆灏迪,薛盛敏,等.肾功能亢进患者万古霉素的药代动力学及谷浓度影响因素研究[J].国际医药卫生导报,2018,24(5):621-628.
    [17] BAKKE V,SPORSEM H,VON DER LIPPEE,et al. Vancomycin levels are frequently subtherapeutic in critically ill patients:a prospective observational study[J].Acta Anaesthesiol Scand,2017,61(6):627-635.
    [18] UDY A A,PUTT M T,SHANMUGATHASAN S,et al. Augmented renal clearance in the Intensive Care Unit:an illustrative case series[J].Int J Antimicrob Agents,2010,35(6):606-608.
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    [20] BARLETTA J F,MANGRAM A J,BYRNE M,et al. Identifying augmented renal clearance in trauma patients:validation of the augmented renal clearance in trauma intensive care scoring system[J].J Trauma Acute Care Surg,2017,82(4):665-671.
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  • 收稿日期:  2018-12-19
  • 修回日期:  2019-03-22

肾功能亢进患者应用万古霉素致急性肾损伤的用药监护

doi: 10.3969/j.issn.1006-0111.2019.03.017
    基金项目:  江苏省苏州市科技发展计划项目(SYSD2016152);江苏省药学会医院药学基金项目(A201613)

摘要: 目的 探讨肾功能亢进患者万古霉素个体化用药中出现急性肾损伤的原因。 方法 对南京医科大学附属苏州医院使用万古霉素且发生急性肾损伤的3个病例进行药学监护,分析使用群体药动学软件预测万古霉素谷浓度准确性差的原因,寻找发生万古霉素急性肾损伤的原因。 结果 在查明患者发生不良反应的原因后,对其进行针对性治疗,均获得较好的控制与转归。 结论 肾功能亢进患者出现万古霉素相关性肾损害主要为联用肾毒性药物、肾脏灌注不足,临床用药中需加强用药监护,提高万古霉素用药安全性。

English Abstract

陆灏迪, 唐莲, 方洁, 薛盛敏, 尚尔宁, 薛苏冬. 肾功能亢进患者应用万古霉素致急性肾损伤的用药监护[J]. 药学实践与服务, 2019, 37(3): 274-278. doi: 10.3969/j.issn.1006-0111.2019.03.017
引用本文: 陆灏迪, 唐莲, 方洁, 薛盛敏, 尚尔宁, 薛苏冬. 肾功能亢进患者应用万古霉素致急性肾损伤的用药监护[J]. 药学实践与服务, 2019, 37(3): 274-278. doi: 10.3969/j.issn.1006-0111.2019.03.017
LU Haodi, TANG Lian, FANG Jie, XUE Shengmin, SHANG Erning, XUE Sudong. Drug monitoring of acute kidney injury induced by vancomycin in patients with augmented renal clearance[J]. Journal of Pharmaceutical Practice and Service, 2019, 37(3): 274-278. doi: 10.3969/j.issn.1006-0111.2019.03.017
Citation: LU Haodi, TANG Lian, FANG Jie, XUE Shengmin, SHANG Erning, XUE Sudong. Drug monitoring of acute kidney injury induced by vancomycin in patients with augmented renal clearance[J]. Journal of Pharmaceutical Practice and Service, 2019, 37(3): 274-278. doi: 10.3969/j.issn.1006-0111.2019.03.017
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