1例甲巯咪唑乳膏治疗口服不耐受的甲状腺功能亢进症病例报道  

A case report of hyperthyroidism with intolerance of oral medication with methimazole cream

作　　者：徐婷[1] 张豫文[2] XU Ting;ZHANG Yuwen(Department of Pharmacy,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Endocrine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院药剂科,上海200025 [2]上海交通大学医学院附属瑞金医院内分泌代谢病科,上海200025

出　　处：《上海交通大学学报（医学版）》2024年第3期412-416,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：嘉定区卫生健康委员会课题(2020-jdyxzdzk-01);上海交通大学医学院附属瑞金医院课题(2017XK02)。

摘　　要：患者老年男性,因“甲巯咪唑口服不耐受,已行放射性碘治疗6月”就诊,存在甲状腺功能亢进症疗效与不良反应的矛盾,结合患者意愿,临床采用甲巯咪唑乳膏局部外用的治疗方案。12周的随诊中,患者症状明显缓解,甲状腺功能明显改善,且血常规和肝功能未出现明显异常。该病例在用药选择上打破常规思维,结合药物效应动力学、药物代谢动力学理论基础和医师临床经验摸索制定甲巯咪唑乳膏初始量和减药量,亦为此制剂用药提供临床参考意见。An elderly male patient sought medical attention due to"intolerance of methimazole tablet and radioiodine treatment for six months".There was a contradiction between the efficacy and adverse drug reaction.Based on the patient's wishes,the clinical treatment of methimazole cream was adopted.During the follow-up of 12 weeks,the patient's symptoms were significantly improved,the indicators of thyroid function declined to normal level,and there were no significant abnormalities in indicators for routine blood test and liver function.The case broke away from conventions in medication selection,showing that the initial and reduced dosage was explored and formulated by combination of the theoretical basis of pharmacodynamics,pharmacokinetics and physician's clinical experience.It also provided clinical reference for the use of the topical formulation.

关 键 词：甲巯咪唑乳膏 甲状腺功能亢进症 粒细胞减少 

分 类 号：R581.1[医药卫生—内分泌]