甲巯咪唑致甲亢患者罕见胆汁淤积性肝炎的病例分析  

A case of cholestatic hepatitis caused by methimazole in patients with hyperthyroidism

作　　者：刘洪月[1] 丁慧 裔照国 LIU Hong-yue;DING Hui;YI Zhao-guo(Department of Pharmacy,Yancheng Third People's Hospital,Yancheng,224000,China.)

机构地区：[1]盐城市第三人民医院药学科,江苏盐城224000

出　　处：《中国处方药》2020年第10期49-50,共2页Journal of China Prescription Drug

摘　　要：目的通过对1例甲巯咪唑致胆汁淤积型肝损伤患者的用药分析,为临床安全合理用药提供参考。方法临床药师参与1例甲巯咪唑致胆汁淤积型肝损伤患者的临床治疗,通过我国药品不良反应关联性评价方法和RUCAM量表分析法确定该例肝损伤与可疑药物的相关程度,对患者保肝治疗方案进行调整,并对患者进行药学监护,提高患者用药安全性。结果通过我国药品不良反应关联性评价方法和RUCAM量表分析法确定该例肝损伤是由甲巯咪唑引起的。临床药师对保肝药物进行调整,最终使用还原性谷胱甘肽、异甘草酸镁联合熊去氧胆酸进行护肝治疗,糖皮质激素缩短疗程。在患者住院期间,临床药师还对患者实行了用药监护,确保患者安全用药。结论临床药师在该甲巯咪唑致罕见胆汁淤积型肝炎的诊治过程中发挥了积极的作用。Objective Through the analysis of a patient with cholestasis liver injury caused by methimazole,provide a reference for clinical safety and rational use of drugs.Methods Clinical pharmacists participated in the clinical treatment of a patient with cholestasis liver injury caused by methimazole.The correlation degree between this case of liver injury and suspicious drugs was determined by the evaluation method of drug adverse reactions and the analysis method of rucam.Reforming the treatment plan of liver protection and providing pharmaceutical care for patients to improve the medication safety of patients.Results The liver injury was caused by methimazole according to the evaluation method of adverse drug reactions and the analysis method of rucam.Clinical pharmacists reformed the liver protecting drugs,and finally used glutathione,magnesium isoglycolate and ursodeoxycholic acid to protect the liver,and glucocorticoids to short the course of treatment.Clinical pharmacists also carried out medication monitoring to ensure the safety of medication during the period of hospitalization.Conclusion The clinical pharmacists played an active role in the diagnosis and treatment of this rare cholestatic hepatitis caused by methimazole.

关 键 词：胆汁淤积型肝炎 甲巯咪唑 药学监护 临床药师 

分 类 号：R969.3[医药卫生—药理学]