药源性假性高甘油三酯的识别和管理

    Drug Induced Pseudo-hypertriglyceridemia: Recognition and Management

    • 摘要:
      目的 开发怀疑药源性假性高甘油三酯血症(pseudo-hypertriglyceridemia,Pseudo-HTG)的临床鉴别流程,有助于临床药师协助医师进行药源性Pseudo-HTG的识别和管理;并提出药学监护途径,为临床药师的工作切入和监护提供参考。
      方法 描述了1例由药物中的甘油辅料导致的Pseudo-HTG的病例,并回顾迄今为止发表的药源性Pseudo-HTG文献,总结病例的临床和生化特征,确定HTG与药物的相关性。
      结果 饮酒史,肾功能损伤是Pseudo-HTG的高危因素,药源性Pseudo-HTG在停止外源性摄入后,甘油三酯值常可在3~5 d内恢复,但伴有肾功能损伤患者若未经连续肾脏替代治疗,恢复时间可能延长至数月。
      结论 药源性Pseudo-HTG的临床鉴别需要医师和药师的互相协作,含甘油药物的大量摄入、导致Pseudo-HTG药物的应用,均可能会造成药源性Pseudo-HTG。临床药师可从建立辅料数据库、跟踪前沿药学研究、患者教育和用药监护方面切入Pseudo-HTG患者的药学监护工作。

       

      Abstract:
      OBJECTIVE  To explore an identification flow chart of drug induced pseudo-hypertriglyceridemia(Pseudo-HTG), which would help clinical pharmacists assist physicians to identify and manage drug induced Pseudo-HTG. Besides, several pharmaceutical care ways were proposed to provide reference for for the work entry and monitoring of clinical pharmacists.
      METHODS  A patient with Pseudo-HTG induced by glycerol excipients was introduced, and drug induced Pseudo-HTG literatures were reviewed. The clinical and biochemical characteristics of drug induced Pseudo-HTG were summarized to determine the correlation between HTG and drugs.
      RESULTS The history of alcohol consumption and renal dysfunction were high-risk factors for Pseudo-HTG. Triglyceride value of drug induced Pseudo-HTG could usually recover within 3–5 d after exogenous intake discontinue. However, the recovery time of patients with renal dysfunction who did not receive continuous renal replacement therapy might be extended to several months.
      CONCLUSION  The clinical identification of drug induced Pseudo-HTG requires collaboration between physicians and pharmacists. The excessive intake of exogenous drugs with glycerol and the use of drugs may lead to drug induced Pseudo-HTG. Clinical pharmacists can enter the pharmaceutical monitoring work of Pseudo HTG patients from the aspects of establishing excipient databases, tracking cutting-edge pharmaceutical research, patient education, and medication monitoring.

       

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