| 摘要: |
| 目的：探讨他克莫司导致肝移植术后幼儿癫痫发生的原因，并通过分析药物代谢基因CYP3A5多态性及药物相互作用机制为个体化给药提供依据。方法：回顾分析1例肝移植患儿术后使用他克莫司后出现癫痫的临床资料，检测药物基因并讨论合用药物的相互作用。结果：该患儿出现癫痫后予地西泮止痉、甘露醇降颅内压等对症治疗有效，药物代谢基因CYP3A5检测结果为CYP3A5*3/*3，依据上述结果调整给药剂量，最终患儿病情稳定。结论：肝移植患儿术后服用他克莫司可致癫痫，应及时给予对症治疗；临床药师应积极参与药物治疗，并依据其代谢酶CYP3A5基因多态性和药物相互作用为患儿制定个体化给药方案。 |
| 关键词: 他克莫司 癫痫 CYP3A5基因多态性 药学服务 |
| DOI： |
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| 基金项目:上海市卫计委青年项目，编号20154Y0019；上海交通大学“医工交叉”项目，编号YG2015QN29；上海市卫生计生系统重要薄弱学科建设项目，编号2016ZB0305-01。 |
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| Pharmaceutical Care for One Infant with Tacrolimus-Induced Epilepsy after Liver Transplantation |
| Li Zhiling1, Liu Ting2, Hu Wenjuan1, Liu Hongxia1, Xing Wenrong1, Sun Huajun1, Cui Yun1 |
| (1. Shanghai Children’s Hospital, Children’s Hospital of Shanghai Jiao Tong University, Shanghai 200064, China; 2. Shenzhen Children’s Hospital, Guangdong Shenzhen 518038, China) |
| Abstract: |
| Objective: To explore the causes of one infant with tacrolimus-induced epilepsy after liver transplantation, and to provide evidence for individualized drug administration by analyzing the polymorphism of drug metabolism gene CYP3A5 and drug interaction mechanism. Methods: The clinical data of one infant with tacrolimus-induced epilepsy after liver transplantation was retrospectively analyzed, and the drug gene was detected and the interaction of drug combinations was discussed. Results: The infant was given diazepam for convulsion relieving and mannitol for intracranial pressure reducing after epilepsy. The detection result of drug metabolism gene CYP3A5 was CYP3A5*3/*3. The dosage was adjusted according to the above results, and the patient’s condition was stable. Conclusion: Tacrolimus can induce epilepsy in children with liver transplantation, which should be given symptomatic treatment in time. Clinical pharmacists should actively participate into the drug therapy and develop individualized administration regimens for children based on the metabolic enzyme CYP3A5 gene polymorphism and drug interactions. |
| Key words: tacrolimus epilepsy CYP3A5 polymorphism pharmaceutical care |
