临床药师参与免疫相关性垂体炎继发肾上腺皮质功能不全诊治的药学实践  

Pharmaceutical practice in the diagnosis and treatment of adrenal insufficiency secondary to immune-related hypophysitis

作　　者：周玉冰[1] 张爱玲[1] 张文达 汪新茹 李朵璐[1] ZHOU Yu-bing;ZHANG Ai-ling;ZHANG Wen-da;WANG Xin-ru;LI Duo-lu(Department of Pharmacy,The First Affiliated Hosptial of Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院药学部,郑州450052

出　　处：《中南药学》2024年第7期1949-1952,共4页Central South Pharmacy

基　　金：国家自然科学基金项目(No.81402266);河南省卫生健康科技创新杰出青年人才培养项目(No.YXKC2020032)。

摘　　要：免疫检查点抑制剂(ICIs)所致免疫相关性垂体炎继发肾上腺皮质功能发生率低,但预后不良,早期识别、及时干预对改善患者临床预后至关重要。本案例中,临床药师根据肺癌患者用药史、不良反应的临床表现及辅助检查结果,结合ICIs相关不良反应谱、相关指南、共识和文献资料,进行药品不良反应关联性分析,协助临床医师为患者明确诊断为ICIs所致免疫相关性垂体炎继发肾上腺皮质功能不全,进一步与临床医师共同制订不良反应处理方案,并对患者进行用药教育。经及时、规范治疗,患者免疫相关性垂体炎继发肾上腺皮质功能不全症状完全纠正。临床药师应用药学专业技术知识,协助临床医师及时、准确识别ICIs相关不良反应,并为患者提供药学监护和用药指导,保障患者用药安全,提高ICIs的临床合理应用水平,体现临床药师专业价值。The incidence of adrenal insufficiency secondary to immune-related hypophysitis caused by immune checkpoint inhibitors(ICIs)is low,but the prognosis is poor.Early identification and timely intervention are crucial for a good outcome.In this pharmaceutical practice,clinical pharmacists assisted clinical physicians in diagnozing adrenal insufficiency secondary to immune-related hypophysitis caused by ICIs,based on patient’s medication history,clinical manifestations of adverse reactions,auxiliary examination results and ICIs-related adverse reaction spectrum,relevant guidelines,consensus,and literature materials.Clinical pharmacists further collaborated with clinical physicians to develop an adverse reaction management plan and monitored medication use in patients.After timely and standardized treatment,the symptoms of adrenal insufficiency secondary to immune-related hypophysitis were completely improved.Clinical pharmacists used pharmaceutical knowledge to help clinical physicians timely and accurately identify adverse reactions related to ICIs,provided medication guidance for patients,ensured medication safety,and improved the rational application of ICIs.

关 键 词：临床药师 免疫检查点抑制剂 免疫相关不良事件 垂体炎 肾上腺皮质功能不全 药学实践 

分 类 号：R969.3[医药卫生—药理学]