1例合并糖尿病的免疫相关性不良反应患者的鉴别、处置和药学监护  

Identification,management and pharmaceutical care of a diabetes mellitus patient with immune-related adverse reaction

作　　者：王春晖 吴薇 李晓宇 吕迁洲 WANG Chunhui;WU Wei;LI Xiaoyu;LYU Qianzhou(Department of Pharmacy,Zhongshan Hospital affiliated to Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院药剂科,上海200032

出　　处：《上海医药》2023年第1期61-64,共4页Shanghai Medical & Pharmaceutical Journal

基　　金：上海市临床重点专科项目(shslczdzk 06504);上海市“医苑新星”青年医学人才培养资助计划项目。

摘　　要：目的 :通过实践探讨临床药师在抗肿瘤治疗多学科团队中的作用。方法 :临床药师运用药源性疾病、药物代谢动力学、特殊人群药物代谢特点等知识对1例合并糖尿病的免疫相关性肾损伤患者的药源性疾病鉴别、处置提出建议,对患者治疗全程进行药学监护。结果:医师接受药师提出的免疫相关性肾损伤和类固醇糖尿病的鉴别诊断和处置建议,根据肾功能调整降糖治疗方案,通过临床药师的药学监护,患者随访肾功能逐渐恢复正常,血糖恢复稳定。结论 :临床药师参与抗肿瘤治疗多学科团队,对抗肿瘤治疗和辅助治疗的临床决策具有积极作用。Objective:To explore the role of clinical pharmacist in multidisciplinary team of antitumor therapy through practice.Methods:Clinical pharmacists used the knowledge of drug-induced diseases,pharmacokinetics,and characteristics of drug metabolism in special population to make suggestions on the identification and treatment of drug-induced diseases for a diabetes mellitus patient with immune-related renal injury,and provide pharmaceutical care for the patient throughout the treatment.Results:The physicians accepted the pharmacists’ recommendations on the differential diagnosis and treatment of immune-related renal injury and glucocorticoid-induced diabetes mellitus.The hypoglycemic treatment plan was adjusted according to the renal function.Through the pharmaceutical care by clinical pharmacist,the patients’ renal function gradually recovered and blood glucose remained stable during follow-up.Conclusion:The participation of clinical pharmacists in the multidisciplinary team of antitumor therapy plays an active role in the clinical decision-making of antitumor therapy and adjuvant therapy.

关 键 词：免疫治疗 信迪利单抗 药源性疾病 急性肾损伤 类固醇糖尿病 

分 类 号：R979.19[医药卫生—药品]