百乐眠胶囊致急性重度肝损伤中的药学实践

目的:探讨临床药师在百乐眠胶囊致药物性肝损伤(Drug-induced liver injury,DILI)药物治疗中的作用。方法:临床药师根据入院用药史问诊,分析百乐眠胶囊中的首乌藤成分和肝损伤的相关性,参与治疗方案的制定、药品不良反应的监护和用药教育,提供患者和医生常见致肝损害中药药品信息,并对致肝损害中药的管理级别和说明书不良反应的修改建议。结果:患者停用百乐眠胶囊并使用保肝、降酶和退黄药物治疗后肝功能明显好转,无药物不良反应发生,并对致肝损害中药品种有所了解。结论:临床药师可通过用药史的问诊、参与治疗方案的制订和提供的药品信息,协助了医生诊断、帮助患者正确使用药物,避免不良反应的发生,提高患者用药安全性。

Pharmaceutical practice of acute severe liver injury induced by Bailemian capsule

OBJECTIVE To explore the role of clinical pharmacists in drug treatment of drug-induced liver injury (DILI) caused by Baile Mian capsule. METHODS The clinical pharmacist inquired about the relationship between the ingredients of Radix Polygoni Multiflori and liver injury according to the medication history of admission, participated in the formulation of treatment plan, the monitoring of adverse drug reactions and medication education, provided the information of common traditional Chinese medicine which caused liver injury to patients and doctors, and proposed to modify management level of traditional Chinese medicine which led to liver injury and the adverse reactions in the package insert. RESULTS The liver function was significantly improved after treatment with hepatoprotective, anti-enzyme and anti-yellow drugs. No adverse drug reactions occurred, and the Chinese herbal medicines with liver damage were known.CONCLUSION Clinical pharmacists can provide advice for diagnosis and help patients to use drugs correctly, so as to avoid the occurrence of adverse reactions, and improve the safety of patients' medications by inquiring about medication history, participating in the formulation of treatment plan and providing drug related information.