从糖皮质激素对血糖的影响探讨临床药师药学监护服务内容

目的：探讨临床药师对使用糖皮质激素患者个体化药学监护服务内容。方法：总结4例不同基础疾病且使用糖皮质激素的住院患者病例，分析患者血糖变化特点，总结糖皮质激素对血糖的影响。结果：糖皮质激素可以明显升高血糖，糖尿病患者糖皮质激素减量过程中容易造成患者低血糖。结论：使用糖皮质激素的患者血糖变化特点各异，主要与糖皮质激素剂量、使用时间、原患疾病等有关。临床药师通过了解相关疾病的临床知识并结合糖皮质激素的药代动力学特点，才能对患者进行准确恰当的药学监护服务。

Investigation of Pharmaceutical Care for the Cases with Blood Glucose Alteration Induced by Glucocorticoids

Objective： To explore the individualized pharmaceutical care of patients with blood glucose alteration induced by glucocorticoids. Methods： The effect of glucocorticoids on blood glucose was summarized by analyzing the alteration characteristics of blood glucose in 4 patients with different general diseases who were administrated with glucocorticoids. Results： Glucocorticoids can elevate the concentration of blood glucose significantly, and diabetic would suffer hypoglycaemia when the dosage of glucocorticoids was decreased. Conclusion： The blood glucose in patients administrated with glueocorticoids varied individually which related to the dosage of glucoeorticoid, the time of administration, accompanying disease, etc. The accurate and appropriate individualized pharmaceutical care should be provided by clinical pharmacist who understands the characteristics and pharmacokinetics of glucocorticoids.