乙肝病毒相关肝移植术后他克莫司联合替诺福韦致1例急性肾损伤的药学服务  

Pharmaceutical care for a patient with acute kidney injury caused by tacrolimus combined with tenofovir after hepatitis B virus related liver transplantation

作　　者：郝朵[1] 刘俊保[1] 吴云强 谭彦 彭苗苗[4] Duo HAO;Jun-Bao LIU;Yun-Qiang WU;Yan TAN;Miao-Miao PENG(Department of Pharmacy,Ordos Central Hospital,Ordos 017000,Inner Mongolia Autonomous Region,China;Department of Pharmacy,Changzhou First People’s Hospital,Changzhou 213000,Jiangsu Province,China;Department of Pharmacy,People’s Hospital of Xiangxi Tujia and Miao Autonomous Prefecture,Jishou 416000,Hunan Province,China;Department of Pharmacy,Affiliated Drum Tower Hospital,Medical School of Nanjing University,Nanjing 210008,China)

机构地区：[1]鄂尔多斯市中心医院药剂科,内蒙古鄂尔多斯017000 [2]常州市第一人民医院药学部,江苏常州213000 [3]湘西土家族苗族自治州人民医院药剂科,湖南吉首416000 [4]南京大学医学院附属鼓楼医院药学部,南京210008

出　　处：《药物流行病学杂志》2023年第3期343-349,共7页Chinese Journal of Pharmacoepidemiology

基　　金：鄂尔多斯市医学重点学科建设项目(鄂卫健发[2020]230号)。

摘　　要：临床药师对1例乙肝病毒感染患者肝移植术后长期服用他克莫司和富马酸替诺福韦二吡呋酯引起药物性肾损伤的关联性进行分析评价,并结合相关指南和文献报道,建议医师将患者用药更换为西罗莫司和富马酸丙酚替诺福韦,同时给予患者用药教育和监护。患者经过相关治疗后肾功能逐渐恢复正常,疾病控制平稳出院。临床药师运用专业知识对药源性疾病患者提供用药建议并开展药学服务,有助于提高患者长期用药的安全性和有效性。The clinical pharmacist systematically analyzed the correlation between drug-induced renal injury caused by long-term administration of tacrolimus and tenofovir dipivoxil fumarate in a patient with hepatitis B virus infection after liver transplantation.In combination with relevant guidelines and literature reports,the clinical pharmacist suggested that doctors replace the patient’s medication with sirolimus and tenofovir alafenamide fumarate,and give the patient medication education and supervision.A?ter relevant treatment,the patient’s renal function gradually returned to normal,and the disease was controlled and discharged smoothly.Clinical pharmacists use their professional knowledge to provide medication advice to patients with drug-induced diseases and carry out pharmaceutical services,which will help improve the safety and effectiveness of long-term medication for patients.

关 键 词：急性肾损伤 他克莫司 替诺福韦 临床药师 药学服务 

分 类 号：R692[医药卫生—泌尿科学]