Pharmacotherapy and monitoring of a patient with severe hyperlipidemia concomitant severe intrahepatic cholestasis of pregnancy
10.12173/j.issn.1005-0698.202402007
- VernacularTitle:1例重度妊娠期肝内胆汁淤积综合征伴严重高脂血症患者的药物治疗与监护
- Author:
Yue CHEN
1
;
Ximei ZHU
;
Caihua YANG
Author Information
1. 南方医科大学南方医院临床药学中心(广州 510515)
- Keywords:
Intrahepatic cholestasis syndrome of pregnancy;
Hyperlipidemia;
Clinical pharmacists;
Pharmaceutical care
- From:
Chinese Journal of Pharmacoepidemiology
2024;33(5):585-590
- CountryChina
- Language:Chinese
-
Abstract:
The article describes the involvement of a clinical pharmacist in the pharmacotherapeutic process of a patient with severe intrahepatic cholestasis of pregnancy concomitant severe hyperlipidemia.Upon admission,the patient presented with triglyceride levels as high as 37.47 mmol·L-1,cholesterol levels of 15.70 mmol·L-1,and total bile acid levels elevated to 64.30 μmol·L-1,indicating a significantly increased risk of complications such as acute pancreatitis and intrauterine fetal demise.How to ensure the safety and efficacy of the medication at the same time is a major challenge in the treatment of this patient.The clinical pharmacist recommended a treatment regimen comprising ursodeoxycholic acid in combination with ademetionine 1,4-butanedisulfonate to lower bile acid levels,alongside fenofibrate combined with ezetimibe to manage hyperlipidemia.After adjustment,triglycerides,cholesterol,and bile acid levels decreasing to 11.10 mmol·L-1,5.94 mmol·L-1,and 49.30 μmol·L-1,respectively.The patient's condition was stable,ultimately resulting in a favorable childbirth outcome.The clinical pharmacist provided personalized pharmaceutical care throughout the patient's treatment,and assisted the clinician to formulate a medication plan in a scientific and rational manner.This article can be served as a reference for the diagnosis and treatment of similar complex obstetric patients.
