| 本文已被：浏览 249次 下载 152次 |
码上扫一扫！ |
| 1 例肾病综合征合并药物性肝损伤患儿的药学监护 |
| 吴亚陵1,2,雷甜甜2,于晓涵3,赵永荣3,周艳1 |
|
|
| (1. 重庆医科大学附属儿童医院,国家儿童健康与疾病临床医学研究中心, 儿童发育疾病研究教育部重点实验室,儿科学重庆市重点实验室,重庆 400014;2. 重庆市妇幼保健院(重庆医科大学附属妇女 儿童医院),重庆 401147;3. 重庆医科大学附属第一医院,重庆 400016) |
|
| 摘要: |
| 目的:探讨临床药师在肾病综合征合并药物性肝损伤患儿药学监护中的作用。 方法:1 例肾病综合征患儿在治疗中出现 肝功能异常,临床药师分析患儿肝功能异常的原因,排除其他因素后考虑药物引起。 参考美国 LiverTox 数据库、中国 Hepatox 数 据库以及相关指南和文献,临床药师建议医师停用怀疑药物,并提供替代治疗方案,开展药物不良反应监测和电话随访。 结果: 临床药师判断卡托普利致患儿肝功能异常可能性大,医师采纳建议并停用卡托普利,选用福辛普利作为替代治疗;此外,临床药 师建议医师将泼尼松调整为甲泼尼龙长期给药、选用复方甘草酸苷进行保肝治疗,调整为上述治疗方案后患儿肝功能逐渐恢复 正常。 结论:临床药师可协助医师查找患儿肝损伤的药物因素、提供治疗方案调整策略,降低患儿发生严重肝损伤的风险。 |
| 关键词: 卡托普利 药物性肝损伤 药学监护 临床药师 |
| DOI：10. 13407/ j. cnki. jpp. 1672-108X. 2023.11.003 |
|
| 基金项目: |
|
| Pharmaceutical Care for a Child with Nephrotic Syndrome Complicated with Drug-Induced Liver Injury |
| Wu Yaling1,2 , Lei Tiantian2 , Yu Xiaohan3 , Zhao Yongrong3 , Zhou Yan1 |
| (1. Children’ s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China; 2. Chongqing Health Center for Women and Children, (Women and Children’ s Hospital Affiliated to Chongqing Medical University), Chongqing 401147, China; 3. The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China) |
| Abstract: |
| Objective: To probe into the role of clinical pharmacists in the pharmaceutical care of children with nephrotic syndrome complicated with drug-induced liver injury. Methods: Abnormal liver function occurred in 1 child with nephrotic syndrome during treatment. The clinical pharmacists participated into analysis of the causes of liver function abnormalities, and considered drug-induced factors after excluding other potential causes. By referring to the American LiverTox database and Chinese Hepatox database, as well as relevant guidelines and literature, the clinical pharmacists recommended that clinicians to discontinue suspected drugs and provided alternative treatment options, performed adverse drug reactions monitoring and telephone follow-up. Results: Clinical pharmacists determined that captopril was likely to induce hepatic abnormalities in the child, and clinicians adopted the recommendation to discontinue captopril and used fosinopril as an alternative treatment. Furthermore, clinical pharmacists suggested clinicians adjusted prednisone to methylprednisolone for long-term administration and selected compound glycyrrhine for liver protection treatment, and the liver function of the child returned to normal state after adjustment of the above treatment regimen. Conclusion: Clinical pharmacists can assist clinicians in identifying drug-related factors contributing to liver injury in children, and provide strategies for treatment adjustments, thereby reducing the risk of severe liver injury in children. |
| Key words: ]captopril drug-induced liver injury pharmaceutical care clinical pharmacists |
