克罗恩病合并低蛋白血症患者对英夫利昔单抗失应答的用药分析与监护

Pharmaceutical care for a Crohn's disease patient with hypoalbuminemia and non-response to infliximab

目的探讨临床药师在克罗恩病患者出现英夫利昔单抗继发性失应答的个体化治疗和用药监护中的作用。方法临床药师参与1例克罗恩病合并低蛋白血症患者的药学实践过程,及时查阅文献对英夫利昔单抗血药浓度检测结果进行解读,分析该药的药动学过程,高度怀疑患者血清白蛋白水平降低致消除加快,浓度降低引起继发性失应答。结果临床药师协助医生调整药物治疗方案,患者经治疗后病情趋于好转。结论临床药师充分了解药物药动学变化,对治疗药物监测结果进行解读,可协助临床发现药物治疗相关问题,有利于建立个体化治疗方案,提高患者生物制剂用药的安全性及有效性。

Objective To investigate the role of clinical pharmacists in individualized treatment and pharmaceutical care for a Crohn’s disease patient with non-response to infliximab.Methods The clinical pharmacist participated in the pharmaceutical care for a Crohn’s disease patient with hypoalbuminemia.Clinical pharmacists interpreted the blood concentration results of infliximab based on literature review,analyzed the pharmacokinetic process of drugs,and suggested that low serum albumin levels may cause the accelerated drug elimination and resulted in reduced drug concentration and secondary non-response.Results Clinical pharmacists assisted clinician adjusting the medication regimen and the patient recovered well after the new treatment plan.Conclusion With good understanding in medication pharmacokinetics and the blood test results,clinical pharmacists can help to solve the drug therapy related problems and establish an individual treatment plan to improve the safety and effectiveness of the biological medications.