Reed Jamie M, Hogan Breann M, Nasser-Ghodsi Navine, Loftus Conor G
Department of Pharmacy, Mayo Clinic, Rochester, MN.
Department of Pharmacy, Indiana University Health, Indianapolis.
Mayo Clin Proc Innov Qual Outcomes. 2021 Apr 8;5(2):520-524. doi: 10.1016/j.mayocpiqo.2020.08.015. eCollection 2021 Apr.
Treatment strategies for hypertriglyceridemia-induced acute pancreatitis are not well defined in the current literature or guidelines. One therapeutic option is an insulin infusion accompanied by a dextrose infusion to avoid hypoglycemia. The purpose of this case report is to highlight dosing considerations for dextrose infusions in nondiabetic patients. We describe a case of hypertriglyceridemia-induced acute pancreatitis in a 34-year-old nondiabetic woman treated with a reduced-dose insulin infusion that was complicated by hypoglycemic episodes requiring dextrose infusion titrations. Empirical initiation of a higher dextrose concentration infusion with glucose level titrations should be considered to avoid hypoglycemia for nondiabetic patients treated with an insulin infusion to lower triglyceride levels. In this case, clinical pharmacy assistance was imperative for successful treatment with a reduced-dose insulin infusion and titrated dextrose infusion in the management of hypertriglyceridemia-induced acute pancreatitis.
高甘油三酯血症性急性胰腺炎的治疗策略在当前文献或指南中尚无明确界定。一种治疗选择是输注胰岛素并同时输注葡萄糖以避免低血糖。本病例报告的目的是强调非糖尿病患者葡萄糖输注的剂量考量。我们描述了一例34岁非糖尿病女性因高甘油三酯血症诱发急性胰腺炎，接受小剂量胰岛素输注治疗，却并发低血糖发作，需要调整葡萄糖输注量的病例。对于接受胰岛素输注以降低甘油三酯水平的非糖尿病患者，应考虑经验性起始较高浓度葡萄糖输注并根据血糖水平进行调整，以避免低血糖。在此病例中，临床药学协助对于使用小剂量胰岛素输注和调整葡萄糖输注量成功治疗高甘油三酯血症性急性胰腺炎至关重要。
