硫唑嘌呤致NUDT15纯合突变的视神经脊髓炎患者骨髓抑制的药学监护实践  

Pharmaceutical care for bone marrow suppression induced by azathioprine in a neuromyelitis optica patient with NUDT15 homozygous mutation

作　　者：彭卓 赖志荣[1] 刘瑶 梁嘉碧[1] 罗文基[1] 陈文礼 Peng Zhuo;Lai Zhirong;Liu Yao;Liang Jiabi;Luo Wenji;Chen Wenli(The Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519000,China)

机构地区：[1]中山大学附属第五医院药学部,广东珠海519000

出　　处：《实用药物与临床》2023年第5期456-460,共5页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨临床药师在硫唑嘌呤致骨髓抑制不良反应个体化治疗中的作用以及NUDT15基因对于预测硫唑嘌呤不良反应的意义。方法临床药师参与1例视神经脊髓炎患者服用硫唑嘌呤后致骨髓抑制的药学监护,依据患者既往用药史与病情变化,结合基因检测结果,评估骨髓抑制与NUDT15基因的相关性,协助医师调整用药方案,并进行相关文献复习。结果经过及时调整用药方案,患者病情得到有效控制。结论临床药师为患者提供合理药学监护,积极排查和处置药物不良反应,提高了患者用药的安全性和有效性。Objective To investigate the role of clinical pharmacists in individualized treatment of adverse reactions of azathioprine-induced myelosuppression,and the significance of NUDT15 gene in predicting adverse reactions of azathioprine.Methods Clinical pharmacists participated in the pharmaceutical care for bone marrow suppression caused by azathioprine in a patient with neuromyelitis optica.According to the patient′s previous drug history and disease changes,and based on the results of genetic testing,the clinical pharmacist assessed the correlation between bone marrow suppression and NUDT15 gene,assisted the physician in adjusting the drug regimen,and reviewed the relevant literature.Results After timely adjustment of the medication regimen,the patient′s condition was effectively controlled.Conclusion Clinical pharmacists provide reasonable pharmaceutical care for patients,actively investigate and deal with adverse drug reactions,and improve the safety and effectiveness of patients′medication.

关 键 词：硫唑嘌呤 NUDT15 骨髓抑制 视神经脊髓炎 药学监护 

分 类 号：R744.52[医药卫生—神经病学与精神病学]