临床药师对小细胞肺癌合并异位促肾上腺皮质激素综合征致低钾血症患者的药学监护
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摘要
目的:探讨临床药师对小细胞肺癌合并异位促肾上腺皮质激素综合征致低钾血症患者开展药学监护的实践。方法:临床药师参与1例小细胞肺癌伴低钾血症患者的治疗过程,提供药学服务。结果:临床药师积极参与,协助医师及早查明了导致低钾血症的原因是该患者并发异位促肾上腺皮质激素综合征,并制订了合理的治疗方案,为患者提供了个体化用药监护。结论:临床药师以自身药学专业知识为切入点,深入临床,提供及时、合理的药学监护,促进了个体化治疗,体现了临床药师的价值。
OBJECTIVE: To investigate the pharmaceutical care for one lung cancer patient with hypokalemia induced by ectopic ACTH syndrome by clinical pharmacists. METHODS: The clinical pharmacists participated in to the treatment process of one lung cancer patient with hypokalemia, and provided pharmaceutical care. RESULTS: The clinical pharmacists actively assisted the clinicians to find out that the hypokalemia was induced by EAS,and then formulated rational therapeutic scheme and provided individualized pharmaceutical care for the patient. CONCLUSIONS: The clinical pharmacists take advantage of the pharmaceutical knowledge as the entry point,offer pharmaceutical care for patients timely and rationally and promote individualize treatment,which reflect the value of clinical pharmacists.
OBJECTIVE: To investigate the pharmaceutical care for one lung cancer patient with hypokalemia induced by ectopic ACTH syndrome by clinical pharmacists. METHODS: The clinical pharmacists participated in to the treatment process of one lung cancer patient with hypokalemia, and provided pharmaceutical care. RESULTS: The clinical pharmacists actively assisted the clinicians to find out that the hypokalemia was induced by EAS,and then formulated rational therapeutic scheme and provided individualized pharmaceutical care for the patient. CONCLUSIONS: The clinical pharmacists take advantage of the pharmaceutical knowledge as the entry point,offer pharmaceutical care for patients timely and rationally and promote individualize treatment,which reflect the value of clinical pharmacists.
引文
[1]Sekiguchi Y,Miyamoto Y,Kasahara I,et al.Ectopic ACTH syndrome caused by desmopressin-responsive thymic neuroendocrine tumor[J].Endocr J,2015,62(5):441-447.
[2]董利平,李晓红,宋娓,等.异位促肾上腺皮质激素综合征2例[J].疑难病杂志,2013,12(2):151-152.
[3]Isidori AM,Lenzi A.ACTH syndrome[J].Arq Bras Endocrinol Metabol,2007,51(8):1217-1225.
[4]陆召麟,郭爱丽,张洁萍,等.20例异位acth综合征的诊断和治疗[J].中华内分泌代谢杂志,1999,15(6):331-333.
[5]贾起华.异位ACTH综合征和库欣病伴低血钾临床特点的比较[J].实用妇科内分泌杂志,2015,2(7):66-67.
[6]Dunn SP,Birtcher KK,Beavers CJ,et al.The role of the clinical pharmacist in the care of patients with cardiovascular disease[J].J Am Coll Cardiol,2015,66(19):2129-2139.
[7]Hirose T,Horichi N,Ohmonori T,et al.PhaseⅡstudy of irinotecan and carboplatin in patients with refractory or relapsed small cell lung cancer[J].Lung Cancer,2003,40(3):333-338.
[8]蔡菊芬,卢红阳,叶魏武,等.依立替康联合卡铂方案二线治疗小细胞肺癌临床观察[J].全科医学临床与教育,2008,6(3):188-190.
[9]宫大鑫,李昱骥,刘屹立,等.异位促肾上腺皮质激素综合征的临床分析[J].中华外科杂志,2002,40(7):525-527.
[10]Sherlock M,Behan LA,Hannon MJ,et al.The modulation of corticosteroid metabolism by hydrocortisone therapy in patients with hypopituitarism increases tissue glucocorticoid exposure[J].Eur J Endocrinol,2015,173(5):583-593.
[11]Mullins LJ,Kenyon CJ,Bailey MA,et al.Mineralocorticoid excess or glucocorticoid insufficiency:renal and metabolic phenotypes in a rat Hsd11b2 knockout model[J].Hypertension,2015,66(3):667-673.
[12]Budyal S,Jadhav SS,Kasaliwal R,et al.Is it worthwhile to screen patients with type 2 diabetes mellitus for subclinical Cushing's syndrome?[J].Endocr Connect,2015,4(4):242-248.
[13]劳丹华,郭清华,陆菊明.库欣综合征合并糖代谢异常41例临床分析[J].临床内科杂志,2006,23(3):170-172.
[14]章考飞,薛美玲,凌艺兰,等.1例小细胞肺癌患者化疗的药学监护[J].中国医院用药评价与分析,2014,14(12):1147-1149.
[15]刘加涛,肖雷,彭万仁,等.从典型病例谈肿瘤专业临床药师培养[J].中国药物评价,2013,30(1):61-64.
[2]董利平,李晓红,宋娓,等.异位促肾上腺皮质激素综合征2例[J].疑难病杂志,2013,12(2):151-152.
[3]Isidori AM,Lenzi A.ACTH syndrome[J].Arq Bras Endocrinol Metabol,2007,51(8):1217-1225.
[4]陆召麟,郭爱丽,张洁萍,等.20例异位acth综合征的诊断和治疗[J].中华内分泌代谢杂志,1999,15(6):331-333.
[5]贾起华.异位ACTH综合征和库欣病伴低血钾临床特点的比较[J].实用妇科内分泌杂志,2015,2(7):66-67.
[6]Dunn SP,Birtcher KK,Beavers CJ,et al.The role of the clinical pharmacist in the care of patients with cardiovascular disease[J].J Am Coll Cardiol,2015,66(19):2129-2139.
[7]Hirose T,Horichi N,Ohmonori T,et al.PhaseⅡstudy of irinotecan and carboplatin in patients with refractory or relapsed small cell lung cancer[J].Lung Cancer,2003,40(3):333-338.
[8]蔡菊芬,卢红阳,叶魏武,等.依立替康联合卡铂方案二线治疗小细胞肺癌临床观察[J].全科医学临床与教育,2008,6(3):188-190.
[9]宫大鑫,李昱骥,刘屹立,等.异位促肾上腺皮质激素综合征的临床分析[J].中华外科杂志,2002,40(7):525-527.
[10]Sherlock M,Behan LA,Hannon MJ,et al.The modulation of corticosteroid metabolism by hydrocortisone therapy in patients with hypopituitarism increases tissue glucocorticoid exposure[J].Eur J Endocrinol,2015,173(5):583-593.
[11]Mullins LJ,Kenyon CJ,Bailey MA,et al.Mineralocorticoid excess or glucocorticoid insufficiency:renal and metabolic phenotypes in a rat Hsd11b2 knockout model[J].Hypertension,2015,66(3):667-673.
[12]Budyal S,Jadhav SS,Kasaliwal R,et al.Is it worthwhile to screen patients with type 2 diabetes mellitus for subclinical Cushing's syndrome?[J].Endocr Connect,2015,4(4):242-248.
[13]劳丹华,郭清华,陆菊明.库欣综合征合并糖代谢异常41例临床分析[J].临床内科杂志,2006,23(3):170-172.
[14]章考飞,薛美玲,凌艺兰,等.1例小细胞肺癌患者化疗的药学监护[J].中国医院用药评价与分析,2014,14(12):1147-1149.
[15]刘加涛,肖雷,彭万仁,等.从典型病例谈肿瘤专业临床药师培养[J].中国药物评价,2013,30(1):61-64.