Treatment optimization for dermatitis medicamentosa in a patient with abnormal liver function associated with infection

ZHANG Xiaogang; ZHAI Xiaobo; JIN Li; LI Yujuan; HE Zhigao

doi:10.3969/j.issn.1006-0111.2017.04.020

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Objective To optimize the treatment plan for dermatitis medicamentosa in a patient with abnormal liver function associated with infection. Methods The culprit medication for drug eruption was identified by reviewing the patient's liver and kidney function, routine blood count, therapeutic drugs, allergic history, by analyzing the characteristics of the compounding medication, combined with literature search on drug eruption diagnosis and treatments. Following the antihistamines and glucocorticoid use guidelines, the treatment plan was optimized by selecting appropriate antihistamines and glucocorticoids based on their metabolism and excretion pathway. Results The rash was poorly controlled after clinical pharmacist's initial recommendation to use chlorpheniramine (intramuscular injection) and cetirizine (oral). The clinical pharmacist further suggested dexamethasone intravenous drip. The patient recovered well with the combination therapy of antihistamines and glucocorticoid. Conclusion When drug eruption occurred, clinical pharmacists should evaluate patient's disease and medications comprehensively, provide timely and accurate pharmaceutical care to patients.

Treatment optimization for dermatitis medicamentosa in a patient with abnormal liver function associated with infection

Department of Pharmacy, Shanghai East Hospital Affiliated to Tongji University, Shanghai 200120, China

Received Date: 2016-03-24

Rev Recd Date: 2017-01-10

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Abstract: Objective To optimize the treatment plan for dermatitis medicamentosa in a patient with abnormal liver function associated with infection. Methods The culprit medication for drug eruption was identified by reviewing the patient's liver and kidney function, routine blood count, therapeutic drugs, allergic history, by analyzing the characteristics of the compounding medication, combined with literature search on drug eruption diagnosis and treatments. Following the antihistamines and glucocorticoid use guidelines, the treatment plan was optimized by selecting appropriate antihistamines and glucocorticoids based on their metabolism and excretion pathway. Results The rash was poorly controlled after clinical pharmacist's initial recommendation to use chlorpheniramine (intramuscular injection) and cetirizine (oral). The clinical pharmacist further suggested dexamethasone intravenous drip. The patient recovered well with the combination therapy of antihistamines and glucocorticoid. Conclusion When drug eruption occurred, clinical pharmacists should evaluate patient's disease and medications comprehensively, provide timely and accurate pharmaceutical care to patients.

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Reference (18)

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Treatment optimization for dermatitis medicamentosa in a patient with abnormal liver function associated with infection

doi: 10.3969/j.issn.1006-0111.2017.04.020

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