1.Pharmaceutical care for a patient with diabetes complicated with suspected hyperlipidemia induced by immuno‐ suppressive agents after liver transplantation
Weimiao LI ; Rongjing SONG ; Chunyan ZHANG ; Lin HUANG ; Xiaohong ZHANG
China Pharmacy 2024;35(18):2310-2314
OBJECTIVE To provide a reference for clinically rational drug use and pharmaceutical care for patients with diabetes complicated with hyperlipidemia induced by immunosuppressive agents after liver transplantation. METHODS Clinical pharmacists participated in the treatment of a patient with diabetes complicated with suspected hyperlipidemia induced by immunosuppressive agents after liver transplantation. Due to the poor glucose control of the patient, the clinical pharmacists assisted the doctor in adjusting the glycemic control plan: subcutaneous injection of 18, 12 and 16 units of Insulin lispro injection before meals, and subcutaneous injection of 16 units of Insulin glargine injection before bedtime. Due to the occurrence of hyperlipidemia in the patient, clinical pharmacists clarified the possible cause of abnormal blood lipid elevation was using immunosuppressants by reviewing the timeline of dose adjustment of immunosuppressive agents and changes in blood lipid levels based on relevant guidelines. Clinical pharmacists suggested using Rosuvastatin calcium tablets 5 mg, qd for lipid-lowering treatment, reducing the dosage of Mycophenolate mofetil capsules and Tacrolimus capsules to 500 mg, bid and 2 mg, bid, respectively. Medication education and pharmaceutical care were also carried out. RESULTS The doctor adopted the advice of the clinical pharmacists. After treatment, the levels of blood glucose and blood lipid in the patient improved, and he was allowed to be discharged with medication. CONCLUSIONS Clinical pharmacists provide pharmaceutical services such as recommending the addition of statins, adjusting the dosage of immunosuppressive agents, and conducting pharmaceutical care to optimize individualized medication plans for patients and ensure the safety and effectiveness of medication.