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臨床藥事照護

臨床藥事照護. 抗生素劑量調整. 抗生素劑量調整 針對特殊族群： ckd 或老年人．．．等 需調整劑量的抗生素，除了 Oxilina ( Ziefmycin ), ceftriaxone,tygacil 外均需調整 臨床上看到診斷有腎衰竭、年齡在 65 歲以上、看腎臟內科等需特別注意. Phenytoin TDM 濃度較正. TDM 針對 Phenytion 進行 TDM 時需加測 Albmin 進行

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臨床藥事照護

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  1. 臨床藥事照護

  2. 抗生素劑量調整 • 抗生素劑量調整 • 針對特殊族群：ckd或老年人．．．等 • 需調整劑量的抗生素，除了Oxilina(Ziefmycin),ceftriaxone,tygacil外均需調整 • 臨床上看到診斷有腎衰竭、年齡在65歲以上、看腎臟內科等需特別注意

  3. PhenytoinTDM濃度較正 • TDM針對Phenytion進行TDM時需加測Albmin進行 • 臨床上遇到使用Phenytion(Aleviatin)時需進行TDM，而因其有高蛋白質結合率，在推估有效的Phenytion濃度時需進行Albmin調整濃度．濃度校正

  4. PhenytoinTDM濃度較正 • Adjustment for serum albumin if CLcr>25ml/min(當病患腎功能正常但血漿中的albumin低時,用下列公式校正phenytoin血中濃度) • Cp • Cp normal binding =  • (1-)[ P/Pnl]+  • Cp→病患的血中濃度 • → 0.1 P→病患的血漿中albumin數值 • Pnl→期望血漿中albumin數值，通常為4.4

  5. PhenytoinTDM濃度較正 Adjustment for serum albumin if CLcr<10ml/min(當病患腎功能異常(eg.ESRD)且血漿中的albumin低時,用下列公式校正phenytoin血中濃度) • Cp • Cp normal binding =  • 0.48(1-)[ P/Pnl]+  • Cp→病患的血中濃度 • → 0.1 • P→病患的血漿中albumin數值 Pnl→期望血漿中albumin數值，通常為4.4

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