1例他克莫司用于CYP3A5*3突变伴肾功能不全药学监护  

Pharmaceutical Care of Tacrolimus in the Treatment of CYP3A5*3 Mutation with Renal Insufficiency:A Case Report

作　　者：张传洲[1] 陈杰[1] 全香花[1] 赵俊[1] 仓怀芹[1] 赵振寰[1] ZHANG Chuanzhou;CHEN Jie;QUAN Xianghua;ZHAO Jun;CANG Huaiqin;ZHAO Zhenhuan(The Affiliated Hospital of Qingdao University,Qingdao,Shandong,China 266003)

机构地区：[1]青岛大学附属医院,山东青岛266003

出　　处：《中国药业》2022年第17期125-128,共4页China Pharmaceuticals

基　　金：中国药学会科技开发中心科普项目[CMEI2020KPYJ(JZX)00207]。

摘　　要：目的 为基因突变伴肾功能不全患者安全、有效应用他克莫司提供参考。方法 临床药师参与1例肾病综合征患者的临床治疗,提出他克莫司基因检测,根据检测结果 CYP3A5*3突变建议他克莫司剂量减半,并进行药学监护。结果 医师采纳临床药师的建议,患者他克莫司血药浓度持续达标,临床症状有效改善,无明显药品不良反应发生。结论 临床药师通过对肾病综合征患者进行药学监护,能提高其用药有效性,减少药品不良反应发生。ObjectiveTo provide a reference for the safe and effective use of tacrolimus in patients with gene mutation and renal insufficiency.MethodsThe clinical pharmacist participated in the clinical treatment of a patient with nephrotic syndrome,and proposed the gene detection for tacrolimus. According to the detection result of CYP3A5*3 mutation,the clinical pharmacist suggested that the dosage of tacrolimus should be reduced by half and pharmaceutical care should be carried out.ResultsThe physicians adopted the suggestions of the clinical pharmacist. The blood concentration of tacrolimus continued to reach the standard,and the clinical symptoms of the patient were effectively improved. No obvious adverse drug reactions occurred.ConclusionThe clinical pharmacist’s practice on the pharmaceutical care for patients with nephrotic syndrome can improve the effectiveness of medication,and reduce the occurrence of adverse drug reactions.

关 键 词：基因突变 肾功能不全 肾病综合征 他克莫司 药学监护 

分 类 号：R95[医药卫生—药学] R983