帕利哌酮致肝移植患者急性药物性肝损伤1例分析  

Case study of a severe drug-induced liver injury caused by paliperidone in a patient after liver transplantation

作　　者：张蔚鹏[1,2] 胡萨萨 Wei-Peng ZHANG;Sa-Sa HU(Department of Pharmacy,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Department of Pharmacy,The Xi'an Eighth Hospital,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院药学部,西安710061 [2]西安市第八医院药剂科,西安710061

出　　处：《药物流行病学杂志》2023年第10期1182-1187,共6页Chinese Journal of Pharmacoepidemiology

摘　　要：临床药师参与1例帕利哌酮导致肝移植患者急性药物性肝损伤(ALT1 733 U·L^(-1),AST 940 U·L^(-1),AKP 703 U·L^(-1))的护肝治疗过程,通过用药分析,并结合RUCAM量表评估,判断可能由于帕利哌酮与氟康唑发生药物相互作用导致其血药浓度过高,继发了急性药物性肝损伤。药师查阅文献资料并结合患者实验室检查特点,对帕利哌酮引起肝损伤的可能机制进行分析,建议停药并给予护肝治疗,最终患者肝功能明显好转。临床药师结合帕利哌酮药动学相关知识和血药浓度监测结果,为临床提供个体化给药建议,充分体现了临床药师的价值。本病例可为帕利哌酮所致药物性肝损伤的判断提供一定的参考依据。Clinical pharmacists participated in the liver protection treatment in a patient after liver transplantation with severe liver injury(ALT 1733 U·L^(-1),AST 940 U·L^(-1),AKP 703 U·L^(-1)).By medication analysis and used the RUCAM scale,pharmacist evaluate acute drugrelated liver injury that may be due to high blood levels of paliperidone that caused by the drug interaction of paliperidone and fluconazole.By reviewing the literature and analyzing the possible mechanisms of paliperidone-induced liver injury combined with the characteristics of patient's laboratory examination,it was suggested that this drug should be stopped in time and liver protection treatment should be carried out.Finally,the patient's liver injury was significantly improved.In this case,the clinical pharmacist combined pharmaceutical knowledge and blood concentration monitoring results to give effective pharmaceutical therapy for the clinic,which fully reflects the value of the clinical pharmacists.This case can provide a certain reference for the severe liver injury caused by paliperidone.

关 键 词：帕利哌酮 肝移植 肝损伤 药品不良反应 

分 类 号：R575[医药卫生—消化系统]