临床药师参与药物致胰岛素自身免疫综合征的诊疗分析

Clinical Pharmacists′Participation in the Diagnosis and Treatment of Drug-Induced Insulin Autoimmune Syndrome

目的为临床药师参与药物致胰岛素自身免疫综合征(IAS)的诊疗提供参考。方法临床药师通过分析药学查房中3例典型IAS病例的治疗经过,总结诊疗流程。结果与临床医师积极有效沟通后,临床药师的建议被采纳,药源性疾病得到及时诊断,提高了药物治疗的有效性。同时,形成了较完整的IAS诊疗流程,建立了致IAS的药品目录。结论药物致IAS为较罕见的药源性疾病。含巯基类药物如甲巯咪唑、丙硫氧嘧啶、硫辛酸等为常见致IAS药物,代谢可生成巯基类药物氢氯吡格雷、泮托拉唑、雷贝拉唑等,也易致IAS。临床药师参与药物致IAS的诊疗,能提高临床救治效果,降低药品不良反应的危害,保障患者安全用药。

Objective To provide a reference for clinical pharmacists to participate in the diagnosis and treatment of drug-induced insulin autoimmune syndrome(IAS).Methods Clinical pharmacists summarized the diagnosis and treatment process by analyzing the treatment process of three typical IAS cases in pharmaceutical ward rounds.Results After active and effective communication with clinical physicians,the suggestions of clinical pharmacists were adopted,and drug-induced diseases were timely diagnosed,which improved the effectiveness of drug treatment.Meanwhile,a relatively complete diagnosis and treatment process of IAS has been formed,and a drug catalog for IAS has been established.Conclusion Drug-induced IAS is a relatively rare drug-induced disease.Sulfhydryl-containing drugs such as methimazole,propylthiouracil,and lipoic acid are common drugs that induce IAS,and they can be metabolized to produce sulfhydryl drugs such as hydroclopidogrel,pantoprazole,rabeprazole,etc.,which are also easy to induce IAS.Clinical pharmacists′participation in the diagnosis and treatment of drug-induced IAS can improve the clinical treatment effect,reduce the harm of adverse drug reactions,and ensure medication safety for patients.