1例注射超大剂量胰岛素致严重低血糖患者的药学监护

Suicidal insulin overdose in a type 2 diabetic patient: pharmaceutical care for a case with severe hypoplycemia

本文讨论临床药师参与1例因注射并口服超大剂量胰岛素注射液致严重低血糖抢救成功的ICU病例,患者经静脉补充葡萄糖注射液并用激素辅助治疗4天后,血糖水平和血清胰岛素水平恢复正常。治疗过程中,临床药师结合胰岛素注射剂药物本身药效学和药动学特点,查阅文献资料给予建议,协助临床团队进行救治工作。本文主要讨论大剂量胰岛素注射后药物对机体的影响及诊疗注意事项,为今后胰岛素过量导致低血糖患者的临床救治提供经验和参考。

This article presents a case of severe hypoglycemia ICU patient caused by suicidal insulin overdose through both subcutaneous injection and oral administration. The patient was successfully rescued after 4-day dextrose intravenous injection combined with hormone therapy. Eventually, her blood glucose level and daily plasma insulin levels recovered to normal levels. Clinical pharmacists participated into the treatment process by reviewing relevant studies and offering suggestions based on the pharmacokinetic and pharmacodynamics of insulin. We discussed the impact on body function after suicidal insulin overdose and factors needed to be noticed during therapy. The purpose of this article is to provide reference and introduce therapeutic experience to the treatment of hypoglycemia patients caused by insulin overdose in the future.