Pharmaceutical care on a patient with rheumatoid arthritis combined with tuberculosis

LIU Ze-yu; ZHENG Yong-chi; REN Qiang; WANG Hong-gui

Abstract：One 51-year-old female patient was admitted to hospital with the pathogeny of chest tightness, shortness of breath for four months as well as fever, cough, expectoration for three months. The clinical diagnoses were secondary tuberculosis of left upper and lower lung, tuberculous pericarditis, left bottom lung bronchiectasis with infection, pulmonary hypertension (mild), rheumatoid arthritis. After admission, sputum culture results of the patient was negative, anti-infectious drugs were administered according to the guide. The clinical pharmacists recommended lfuconazole for double of the ifrst dose. Considering that the patient with rheumatoid arthritis 30 years, clinical pharmacists suggested pyrazinamide replaced by moxilfoxacin, rifampicin replaced by rifapentine. After ifve days treatment, the pathogeny of cough and expectoration of the patient relieved, and no fever occurred again. During the treatment, triglycerides and liver enzymes of the patient were elevated, clinical pharmacists recommended that the lipid and glucose injection should be stopped, and then triglycerides of patient reduced to normal with the drug withdrawal, and suggested to stop using liver-protection medicine. At the same time, the clinical pharmacists provided medication education for the patient including antituberculosis treatment principle, possible adverse reactions of the drugs as well as monitoring of liver function and blood routine. Finally, the patient was discharged from the hospital with the symptomatic improvement.