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复方苁蓉益智胶囊致血管性痴呆患者药物性肝损伤的药学监护:1 例报告。

Pharmaceutical care of vascular dementia patients with drug-induced liver injury caused by the Compound Congrong Yizhi Capsules: a case report.

机构信息

The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China.

出版信息

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4693-4697. doi: 10.26355/eurrev_202305_32481.

Abstract

BACKGROUND

Drug-induced liver injury (DILI) is a newly discovered adverse drug reaction of Compound Congrong Yizhi Capsules (CCYC) in the treatment of vascular dementia (VD), and targeted pharmaceutical care is urgently needed to be explored.

CASE REPORT

DILI was found in a patient who was admitted to the hospital with a diagnosis of VD after treatment with Compound Congrong Yizhi Capsules. According to the guidelines, the patient was initially treated with magnesium isoglycyrrhizinate injection. After 4 days, the clinical pharmacist monitored liver function: alanine aminotransferase (ALT): 153 IU/L, aspartate aminotransferase (AST): 160 IU/L, total bilirubin (TBil): 4.5 µmol/L, and alkaline phosphatase (ALP): 551 IU/L, which indicated that DILI was further aggravated. In addition, the increased blood pressure (156/65 mmHg) indicated the requirement to adjust the medication. Then, the hepatoprotective drugs were adjusted with reduced glutathione combined with ursodeoxycholic acid. After 12 days of treatment, the liver function was significantly improved, the clinical treatment was effective, and the blood pressure was controlled stably with no obvious adverse drug reactions.

CONCLUSIONS

With pharmaceutical care guided by clinical pharmacists, the DILI caused by Compound Congrong Yizhi capsules could be reversed to improve the clinical outcome and avoid the occurrence of serious complications.

摘要

背景

复方苁蓉益智胶囊(CCYC)在治疗血管性痴呆(VD)中出现了一种新的药物不良反应——药物性肝损伤(DILI),需要探索有针对性的药学监护。

病例报告

在使用复方苁蓉益智胶囊治疗血管性痴呆的患者中,发现了 DILI。根据指南,患者最初接受了门冬氨酸鸟氨酸治疗。4 天后,临床药师监测肝功能:丙氨酸氨基转移酶(ALT):153IU/L,天冬氨酸氨基转移酶(AST):160IU/L,总胆红素(TBil):4.5µmol/L,碱性磷酸酶(ALP):551IU/L,这表明 DILI 进一步加重。此外,血压升高(156/65mmHg)表明需要调整药物。然后,用还原型谷胱甘肽联合熊去氧胆酸调整了保肝药物。治疗 12 天后,肝功能明显改善,临床治疗有效,血压稳定控制,无明显药物不良反应。

结论

在临床药师的药学监护指导下,复方苁蓉益智胶囊引起的 DILI 可逆转,从而改善临床结局,避免严重并发症的发生。

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