从丙基硫氧嘧啶不良反应的识别与干预谈药师的临床药学实践

ChineseJournalofNewDrugs2009,18(22)218920091822[],,,:(010)669288606,E2mail:[e-mail][],,,:[phone],E2mail:[e-mail]1,2,2,1(1,100191;2,100142)[]::561,,,,:,,:,[];;;;[]R95[]A[]1003-3734(2009)22-2189-04ClinicalpharmacypracticebymeansofidentificationandinterventionofadversereactionsofpropylthiouracilLIUMin1,2,LIZhong2dong2,SHAOHong1(1DepartmentofPharmacyAdministrationandClinicalPharmacy,SchoolofPharmaceuticalSciences,PekingUniversity,Beijing100191,China;2DepartmentofPharmacy,GeneralHospitalofAirForce,Beijing100142,China)[Abstract]objective:Tofigureoutabreakthroughpointforpharmaciststodevelopclinicalpharmacyprac2ticebymeansofidentificationofadversereactionsofpropylthiouracil.Methods:Thecases(n=561)ofadversere2actionsofpropylthiouracilwerecollectedinliterature,andtheirpopularregularitywasdisinterred.Theadversere2actionsofpropylthiouracilwereidentifiedfromclinicalmedicationcasesandintervenedbypharmacists.Results:Onthebasisofdruginformatics,theadversereactionsofpropylthiouracilwerefullyunderstoodandefficientlyusedinclinicalpharmacypractice.Conclusion:Themodeofclinicalpharmacypracticeintroducedbytheidentificationofadversedrugreactionsasabreakthroughpointisworthofcommendation.[Keywords]propylthiouracil;adversedrugreaction;informationcollecting;pharmacist;clinicalpharmacypractice,()[1]:,,,,,,,,,,,,11,,23,22ChineseJournalofNewDrugs2009,18(22)219020091822,,2008,,FT3:17.41pmolL-1,FT4:35.51pmolL-1;CT:,:;,,:916T34.11nmolL-1,aTPO:1300UmL-1,T39151pmolL-1,aTg34.5UmL-1,T426.43pmolL-1,T4189.89nmolL-1;TSH0.00IUmL-1,3.9109L-1,55.3%,1.4109L-1150mg,tid;120mg,tid105107,,:T36.36nmolL-1,T4240.06nmolL-1,T313.98pmolL-1,T438.69pmolL-1108,3815,,,,:2.4109L-1,6.071012L-1,171gL-1,1.14109L-1,,(21)3g,bid3d,,,,500mg,iv,qd,014g,iv,qd,40mg,tid;40mg,tid,B420mg,tid,3d,,39.5,2.0109L-1,5.771012L-1,165gL-1,0.85109L-1,CRP8.49mgL-1,,,,,,,,,,,,,22.1,,561,,500,,(ANCA):,4.31,2040[100400mgd-1,122]1h[2],17[3],ANCA,,1,ANCA21,[4]55120,23[5](,80%),[6-7],,,[8-9](),[10]()80ChineseJournalofNewDrugs2009,18(22)2191200918222ANCA[11][12-13]:[14-15][16-17][18-19]4919[20],,:[21]43[22][23][24][25][26][27][28]2242432.2,,,2.3,,,200mgd-1,1014,,,,:2.2109L-1,5.661012L-1,0.71109L-13d,,,74IUL-11021,3.4109L-1,1.6109L-1,T36.32nmolL-1,T4284.82nmolL-1,T316.38pmolL-1,T452.92pmolL-1,,300mgd-1,3,,1117,4.2109L-1,2.26109L-1,T34.39nmolL-1,T4195.07nmolL-1,T310.6pmolL-1,T425.85pmolL-1,,,,4d,,,,,,,,3,:,,,,,,2015(BestPractice2015)Applyevidence-basedmethodstotheimprovementofmedicationthera2py(),,,2,,,,,,,,,ChineseJournalofNewDrugs2009,18(22)219220091822,,,,;,,,,,,,[][1],.[M].:,2003:220.[2],,.[J].,2004,27(5):506.[3]KUDOHY,KURODAS,SHIMAMOTOK.Propylthiouracil-in2ducedrapidlyprogressiveglomerulonephritisassociatedwithanti2neutrophilcytoplasmicautoantibodies[J].ClinNephrol,1997,48(1):41-43.[4]DEIDIKERR,DEMELLODE.Propylthiouracil-inducedfulmi2nanthepatitis:casereportandreviewoftheliterature[J].Pedi2atrPatholLabMed,1996,16(5):845-852.[5],.64[J].,2005,10(8):554-555.[6]AKAMIZUT,OZAKIS,HIRATANIH.Drug2inducedneutrope2niaassociatedwithanti2neutrophilcytoplasmicantibodies(AN2CA):possibleinvolvementofcomplementingranulocytecytotox2icity[J].ClinExpImmunol,2002,127(1):92-98.[7],.1[J].,2007,16(6):380.[8]BISWASN,AHNYH,GOLDMANJM,etal.Aplasticanemiaassociatedwithantithyroiddrugs[J].AmJMedSci,1991,301(3):190-194.[9]AKSOYM,ERDEMS.Aplasticanemiaafterpropylthiouracil[J].Lancet,1968,1(7556):1379.[10]SAMMONTJ,PEDENVH,WITZLEBENC.Disseminatedin2travascularcoagulationcomplicatingpropylthiouraciltherapy.Acasedescriptionofa162year2oldgirl[J].ClinPediatr(Phila),1971,10(12):739-742.[11]FANGJT,HUANGCC.Propylthiouracil2inducedacuteintersti2tialnephritiswithacuterenalfailurerequiringhaemodialysis:suc2cessfultherapywithsteroids[J].NephrolDialTransplant,1998,13(3):757-758.[12],.2[J].,2006,15(2):229-257.[13]NAKAMORIY,TOMINAGAT,INOUEY,etal.Propylthiouracil(PTU)2inducedvasculitisassociatedwithantineutrophilantibodyagainstmyeloperoxidase(MPO2ANCA)[J].InternMed,2003,42(6):529-533.[14]WINTERSMJ,HURLEYRM,LIRENMANDS.ANCA2positiveglomerulonephritisandIgAnephropathyinapatientonpropyl2thiouracil[J].PediatrNephrol,2002,17(4):257-260.[15]FUJIEDAM,NAGATAM,AKIOKAY.Antineutrophilcytoplasmicantibody2positivecrescenticglomerulonephritisassociatedwithprop2ylthiouraciltherapy[J].ActaPaediatrJpn,1998,40(3):286-289.[16],,.ANCA5[J].,2007,15(2):102-103.[17]KITAHARAT,HIROMURAK,MAEZAWA.ACaseofpropyl2thiouracil2inducedvasculitisassociatedwithanti2neutrophilcyto2plasmicantibody(ANCA);reviewofliterature[J].ClinNeph2rol,1997,47(5):336-340.[18],.3[J].,2005,14(14):1880-1881.[19]NAKAHAMAH,NAKAMURAH,KITADAO,etal.Chronicdrug2inducedtubulointerstitialnephritiswithrenalfailureassoci2atedwithpropylthiouraciltherapy[J].ClinExpObstetGynecol,2002,29(4):304-305.[20]NOMIYAMAY,YATERAK,KAWAJIRIT.AcaseofMPO-ANCApositivevasculitisassociatedwithdiffusealveolarhemor2rhageandvariouscardiacconductingsystemabnormalitiesfollow2ingpropylthiouraciltreatment[J].NihonKokyukiGakkaiZasshi,2004,42(4):324-329.[21]EL2FAKIHR,CHEHABBM,SHAVERT.Thionamide-inducedvasculitis: