1例甲巯咪唑致混合型药物性肝损伤患者的药学监护  

Pharmaceutical care on a patient with methimazole-induced liver injury

作　　者：李瑞珺[1] 钱方[2] 陆瑜[1] 朱余兵[2] 

机构地区：[1]解放军第454医院药学部,江苏南京210002 [2]南京市第一医院药学部,江苏南京210002

出　　处：《中国药物应用与监测》2016年第4期227-230,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：1例37岁女性患者,因"心悸消瘦1个月,肝酶明显升高"入院,入院诊断为"甲亢、肝功能损伤"。入院后,给予该患者口服甲巯咪唑行抗甲亢治疗,10 d后复查肝功结果显示肝酶升高,遂停用甲巯咪唑并行^(131)I同位素治疗,之后再次小剂量给予甲巯咪唑,发现患者肝酶急剧升高。临床药师根据患者既往检查指标,对患者整体治疗过程进行药学监护,考虑可能是甲巯咪唑导致的药物性肝损伤。临床药师结合诊治指南明确药物性肝损伤规范诊断,协助医师优化治疗方案,同时对患者进行用药教育。经停药及保肝治疗10 d,患者肝酶恢复正常予以出院。One 37-year-old female patient was admitted to hospital because of palpitations and emaciation for one month and significant elevation of liver enzyme. The patient was diagnosed with hyperthyroidism and liver injury. The patient received methimazole orally for the treatment of hyperthyroidism, while elevation of liver enzyme was discovered after 10 days of methimazole therapy. Methimazole was stopped, and ^131I therapy was used. After that, the patient took low dose of methimazole, the sharp rise of liver enzyme was found. Clinical pharmacists provided pharmaceutical care over the whole treatment period. According to previous examination indexes, the clinical pharmacists highly suspected the liver injury was induced by methimazole. Combining with treatment guidelines, clinical pharmacists assisted physicians to clarify the diagnosis of drug-induced liver injury and optimize treatment regimens, and the pharmaceutical care and medication education were carried out during the treatment. After withdrawal of methimazole and symptomatic treatment for 10 days, the patient was discharged with an improved condition.

关 键 词：甲巯咪唑 药物性肝损伤 药学监护 临床药师 

分 类 号：R575[医药卫生—消化系统]