1例信迪利单抗致药物性肝损伤的药学监护实践  

Pharmaceutical Care of a Patient with Drug-Induced Liver Injury Caused by Sintilimab

作　　者：王玉[1] 闫欣欣[1] 毕兰青 郭芬 时建明[1] WANG Yu;YAN Xinxin;BI Lanqing;GUO Fen;SHI Jianming(Suzhou Hospital Affiliated to Nanjing Medical University,Suzhou,Jiangsu,China 215008)

机构地区：[1]南京医科大学附属苏州医院,江苏苏州215008

出　　处：《中国药业》2022年第18期117-119,共3页China Pharmaceuticals

基　　金：江苏省自然科学基金青年基金项目[BK20190189]。

摘　　要：目的探讨肿瘤免疫治疗过程中药学监护的作用。方法临床药师从治疗药物的选择、药物剂量、疗效评估及安全性评价等方面对1例信迪利单抗致药物性肝损伤(DILI)患者进行药学监护。监护内容包括停用信迪利单抗和紫杉醇白蛋白,改用甲泼尼龙并逐渐减量,后改用泼尼松(用药期间予雷贝拉唑、多烯磷脂酰胆碱、异甘草酸镁),并视患者肝功能恢复情况决定是否继续用药。结果医师采纳药师建议,患者的肝功能恢复正常。结论临床药师参与抗肿瘤免疫治疗药物致DILI的药学监护,可促进合理用药,提高治疗的安全性和有效性。Objective To investigate the role of clinical pharmacists in pharmaceutical care in tumor immunotherapy.Methods Clinical pharmacists provided pharmaceutical care for a patient with drug-induced liver injury(DILI)caused by sintilimab from the selection of treatment drugs,drug dose,efficacy evaluation and safety evaluation.The contents of pharmaceutical care included stopping sintilimab and paclitaxel albumin,changing to methylprednisolone and gradually decreasing,and then changing to prednisone(rabeprazole,polyene phosphatidylcholine and magnesium isoglycyrrhizate were given during the administration of prednisone),and the patient's continued medication was determined according to the recovery of liver function.Results The doctor adopted the pharmacists'advice and the patient's liver function gradually recovered to normal.Conclusion The participation of clinical pharmacists in the pharmaceutical care of DILI caused by anti-tumor immunotherapy drugs can promote rational drug use and improve the safety and effectiveness of treatment.

关 键 词：药物性肝损伤 信迪利单抗 药学监护 临床药师 合理用药 

分 类 号：R969.3[医药卫生—药理学] R979.1[医药卫生—药学]