1例重度溃疡性结肠炎糖皮质激素抵抗患者的环孢素转换治疗

Treatment of a Case of Severe Ulcerative Colitis with Glucocorticoid Resistance Patient by Cyclosporine Conversion

关键词:  临床药师  环孢素  糖皮质激素抵抗  重度溃疡性结肠炎

Key words:  clinical pharmacist  cyclosporin  glucocorticoid resistance  severe ulcerative colitis

摘要:

目的 探讨临床药师在环孢素转换治疗糖皮质激素抵抗的重度溃疡性结肠炎过程中的作用。方法 临床药师全程参与1例重度溃疡性结肠炎糖皮质激素抵抗患者的治疗经过，协助医师进行转换药物的选择，根据患者病情变化和环孢素的血药浓度监测结果调整给药剂量，监测临床疗效、药物相互作用和不良反应，并为患者提供用药教育。结果 选择环孢素作为转换药物，调整环孢素剂量以确保其血药浓度维持在有效治疗窗内，避免不良反应的发生，患者病情好转出院；对患者进行环孢素应用教育，提高了患者用药的依从性。结论 临床药师对重度溃疡性结肠炎糖皮质激素抵抗患者的药物治疗方案进行优化，促进合理用药，为临床同类患者的用药方案提供参考，同时体现了临床药师的重要价值。

Abstract:

OBJECTIVE To explore the role of clinical pharmacists in the treatment of severe ulcerative colitis with glucocorticoid resistance by cyclosporine conversion. METHODS Clinical pharmacists fully participated in the treatment of a case of severe ulcerative colitis with glucocorticoid resistance, and assisted the physician in the selection of switching drugs, the dosage was adjusted according to the patient's condition change and results of blood concentration monitoring of cyclosporine, to monitor clinical efficacy, drug interactions and adverse reactions, and to provide medication education for patients. RESULTS Cyclosporine was selected as the conversion drug, and the dose of cyclosporine was adjusted to ensure that its blood concentration remained within the effective therapeutic window, so as to avoid adverse reactions, and the patient's condition improved and discharged; the patient was given a detailed and comprehensive application education of cyclosporine, and the patient compliance with medication was improved. CONCLUSION Clinical pharmacists optimize the drug therapy for patients with severe ulcerative colitis with glucocorticoid resistance, to promote rational drug use, and provide a reference for the drug treatment plan of similar clinical patients, and embody the important value of clinical pharmacists.