返回 
加入收藏
恩格列净致非高血糖性糖尿病酮症酸中毒患者的药学监护
x
请在关注微信后，向客服人员索取文件
| 篇名： | 恩格列净致非高血糖性糖尿病酮症酸中毒患者的药学监护 |
| TITLE： | Pharmaceutical care for a patient with empagliflozin-induced euglycemic diabetic ketoacidosis |
| 摘要： | 目的 为使用恩格列净后出现非高血糖性糖尿病酮症酸中毒（euDKA）的2型糖尿病（T2DM）合并肢带型肌营养不良症（LGMD）患者的药学监护提供参考。方法临床药师参与1例服用恩格列净后出现euDKA的T2DM合并LGMD患者的药学监护过程。临床药师结合患者近期服用药物及疾病史，判断患者发生euDKA与恩格列净的关联性为“很可能”。针对euDKA，临床药师建议立即停用恩格列净和二甲双胍，并建议将静脉滴注5%葡萄糖注射液改为静脉滴注10%葡萄糖注射液进行液体复苏，密切监测患者的动脉血气、电解质、血/尿酮体等指标，协助医生判断补液及胰岛素停药时间，和医生协商调整降糖方案，教育患者避免再次使用恩格列净及其他钠-葡萄糖耦联转运体2抑制剂（SGLT2i）。结果医生采纳临床药师建议。患者经治疗后病情好转，准予带药出院。结论euDKA是SGLT2i较为罕见且严重的不良反应，而LGMD是euDKA的易患人群。临床药师通过评估euDKA与恩格列净的关联性、调整用药方案、开展药学监护等药学服务手段，协助医生制定个体化用药方案，同时对患者进行用药宣教，保障患者用药安全。 |
| ABSTRACT： | OBJECTIVE To provide a reference for the pharmaceutical care of a patient with type 2 diabetes mellitus （T2DM） and limb-girdle muscular dystrophy （LGMD） who developed euglycemic diabetic ketoacidosis （euDKA） after taking empagliflozin. METHODS Clinical pharmacists provided pharmaceutical care for a patient with T2DM and LGMD who developed euDKA after taking empagliflozin. According to the patient’s recent use of medications and his conditions， clinical pharmacists assessed the correlation between euDKA and empagliflozin as “very likely”. As to euDKA， clinical pharmacists suggested discontinuing empagliflozin and metformin， and giving intravenous infusion of 10% Glucose injection instead of 5% Glucose injection for fluid resuscitation. Clinical pharmacists monitored the patient’s laboratory indicators such as arterial blood gas analysis， blood/urine ketones and electrolytes. They assisted physicians to decide when to stop intravenous supplements of liquid and insulin. Clinical pharmacists also assisted physicians to adjust the antidiabetic drugs and educated the patient to avoid empagliflozin or other sodium- glucose linked transporter 2 inhibitors （SGLT2i）. RESULTS Physicians adopted the suggestions of clinical pharmacists. After treatment， the patient’s condition improved， and he was allowed to be discharged with medication. CONCLUSIONS euDKA is a relatively rare and serious adverse reaction associated with SGLT2i， and the patients with LGMD are susceptible to euDKA. Clinical pharmacists assist physicians in developing personalized medication plans by evaluating the association between euDKA and empagliflozin， adjusting medication regimens，conducting pharmaceutical monitoring，and other pharmaceutical services. Meanwhile， they provide medication education to patients to ensure their medication safety. |
| 期刊： | 2025年第36卷第02期 |
| 作者： | 杨立莉；李琦；王辉；高瑞龙；毛敏 |
| AUTHORS： | YANG Lili，LI Qi，WANG Hui，GAO Ruilong，MAO Min |
| 关键字： | 恩格列净；非高血糖性糖尿病酮症酸中毒；肢带型肌营养不良症；2型糖尿病；钠-葡萄糖耦联转运体2抑制剂；药学监护 |
| KEYWORDS： | empagliflozin； euglycemic diabetic ketoacidosis； limb-girdle muscular dystrophy； type 2 diabetes mellitus； sodium- |
| 阅读数： | 6 次 |
| 本月下载数： | 0 次 |
* 注：未经本站明确许可，任何网站不得非法盗链资源下载连接及抄袭本站原创内容资源!在此感谢您的支持与合作！
