1例布洛芬致亚急性肝衰竭的病例分析与药学监护

Case analysis and pharmaceutical care of a subacute liver failure caused by ibuprofen

1例患者因发热口服布洛芬颗粒2袋及感冒胶囊2粒,2 d后皮肤巩膜黄染,诊断为急性黄疸型肝炎,经治疗后好转。后因发热再次口服布洛芬混悬液20 mL导致亚急性肝衰竭(subacute liver failure,SALF)入院,给予乙酰半胱氨酸、异甘草酸镁、多烯磷脂酰胆碱、促肝细胞生长素、腺苷蛋氨酸等保肝、退黄,补充凝血因子、输注血浆、人工肝等治疗,15 d后肝功能好转出院。治疗期间,临床药师分析总结了布洛芬致SALF的原因,协助医生制定合理治疗方案,对患者实施了全面的药学监护,为保障患者用药安全、有效发挥了积极作用。

A female patient was treated with oral ibuprofen granules 2 bags and 2 pills of cold capsules for fever.Two days later,the skin and sclera were yellow,and she was diagnosed as acute jaundice hepatitis.After treatment,she was improved.Then subacute liver failure(SALF)was caused by oral ibuprofen suspension 20 mL again for fever.The patient′s liver function gradually improved after the hepatoprotective therapy with acetylcysteine,magnesium isoglycyrrhizinate polyene phosphatidylcholine,hepatocyte growth promoting factor,adenosylmethionine,and supplemented by coagulation factor,plasma infusion,and artificial liver.After 15 days of treatment,the patient′s liver function improved and discharged.During the treatment,clinical pharmacists analyzed the causes of ibuprofen-induced SALF,assisted doctors to formulate reasonable treatment plans,implemented comprehensive pharmaceutical care for patients,and played an active role in ensuring the safety and effectiveness of drug use.