临床药师参与1例甲巯咪唑致胰岛素自身免疫综合征的药学监护

Clinical Pharmacists Participated in the Pharmaceutical Care of a Patient with Insulin Autoimmune Syndrome Caused by Methimazole

目的 探讨临床药师在内分泌科罕见疾病诊治中的作用。方法 临床药师对1例诱因不明但反复出现严重低血糖的患者的治疗全过程进行干预,查明其发生低血糖的原因,提出合理化用药方案,就其诊疗全过程进行药学监护。结果 临床药师先是对患者进行问诊了解其用药史,随后查询相关文献,考虑患者频繁发生低血糖的原因可能与服用含有巯基的甲巯咪唑导致的胰岛素自身免疫综合征有关,协助医生优化治疗方案并开展药学监护。经治疗后,患者出现低血糖的次数减少。结论 临床药师充分利用自身专业的优势,发挥主观能动性,寻找融入临床治疗团队的切入点,在识别药物结构,优化治疗方案以及开展药学监护方面发挥了重要推动作用。

Objective To study the drug treatment of clinical pharmacists for rare diseases in endocrinology department and carry out pharmaceutical care.Methods The clinical pharmacists intervened in the whole treatment process of a patient with unknown inducement but severe hypoglycemia repeatedly,and found out the cause of hypoglycemia,proposed treatment analysis recommendations carried out pharmaceutical monitoring for the whole process of diagnosis and treatment.Results The clinical pharmacist first inquired about the patient's medication history,and then inquired about the relevant literature.It was considered that the reason why the patient frequently suffered from hypoglycemia might be related to the insulin autoimmune syndrome caused by drugs sulfhydryl-containing methimazole,the clinical pharmacist assisted the physician to opyimized the treatment plan and carried out pharmaceutical care.After symptomatic treatment,the number of hypoglycemia in patient decreased.Conclusion Clinical pharmacists should be good at making use of their own professional advantages,give play to their subjective initiative,find an entry point into the clinical treatment team,and have played an important role in identifying drug structures,optimizing treatment plans,and carrying out pharmaceutical monitoring.