Pharmaceutical care of a child with congenital hyperinsulinemia and establishment of self-supplied drugs safety management mode
10.3760/cma.j.cn114015-20200702-00733
- VernacularTitle:先天性高胰岛素血症患儿的药学监护及自备药品安全管理模式的建立
- Author:
Jia YANG
1
;
Yongxian JIANG
1
;
Wenwen CHEN
1
;
Wanjun TAO
1
;
Gen LI
1
Author Information
1. 电子科技大学医学院附属医院·成都市妇女儿童中心医院药学部，成都 611731
- Publication Type:Journal Article
- Keywords:
Congenital hyperinsulinism;
Diazoxide;
Medication errors;
Pharmacists;
Safety management
- From:
Adverse Drug Reactions Journal
2021;23(4):202-204
- CountryChina
- Language:Chinese
-
Abstract:
An one-month-old boy was treated with diazoxide capsules purchased by his parents from abroad for congenital hyperinsulinemia. In order to correct his hypoglycemia, the treatment plan was designed as follows: diazoxide capsules with an initial dose of 8.72 mg orally thrice daily [5 mg/(kg·d)] and intravenously high concentration glucose were given at the same time, then the supplement of intravenous glucose was gradually reduced and the dose of diazoxide was gradually increased under close monitoring of blood glucose levels, and finally the intravenous glucose was stopped with the stable blood glucose level (≥3.9 mmol/L). During the first 7 days of treatment, the dose of intravenous glucose and diazoxide were adjusted as planned, the child′s blood glucose was 3.1-5.3 mmol/L, and no hypoglycemia occurred. On the 8th day, the pharmacist found that the child was not awake and the blood glucose was 2.2 mmol/L during patient rounds. After questioning his parents, it was found that the dose of diazoxide was reduced to the initial dose by the parents themselves, leading to an episode of hypoglycemia, which was a medication error caused by the lack of self-supplied drugs management. The pharmacist immediately intervened on his parents′ treatment adherence. The dose of diazoxide was re-adjusted and the child′s blood glucose returned to normal. With the increase of the diazoxide dose, the child developed an adverse reaction of water and sodium retention. The addition of hydrochlorothiazide was recommended by the pharmacists after reviewing previous literatures and the adverse reaction of the child disappeared. Through this case, the clinical management standard of self-supplied drugs for special diseases and the database of safe drug use were established and a multi-disciplinary team for joint services consisting physicians and pharmacists was formed in the hospital under the efforts of clinical pharmacists. The safety management of medication in treatment of hospitalized and discharged children was strengthened and good results have been achieved.
