摘要
本文通过总结2例结核病导致肾上腺皮质功能低下(Addison病)患者的治疗情况,分析此类患者的药学监护要点。例1:41a女性原发性肾上腺皮质功能减退症患者,应用糖皮质激素后乏力症状明显改善,但与抗结核药物利福平联用后症状加重,提示利福平和糖皮质激素存在药物相互作用,最终糖皮质激素替代治疗方案为强的松每天早上5mg,每天下午2.5mg,患者症状明显改善。例2:56a男性Addison患者,同时使用糖皮质激素和利福平,生理替代剂量不能有效缓解症状,出院时替代治疗方案为强的松5mg,每天1次,9α-氟氢可的松每天下午0.1mg,地塞米松每天下午0.375mg。2个月后复查8:00ACTH为>275pmol·L-1,皮质醇44.41nmol·L-1,乏力明显缓解,但皮肤色素沉着未见明显减轻,提示糖皮质激素剂量不足。
The therapies of 2 patients with adrenocortical insufficiency （Addison＇ s disease） induced by tuberculosis were summarized, and the pharmaceutical care on the patients was analyzed. Patient l, a 41-year-old female with adrenocortical insufficiency was administrated with glucocorticoid, and her hypodynamia symptom relieved, but the above symptom aggravated after rifampicin was added, which indicated the drug interaction between glucocorticoid and rifampicin. The glucocorticoid replacement therapy regimen was prednisone 5 mg in the morning, 2.5 mg in the afternoon, and her symptom improved significantly. Patient 2, a 56-year-old male with Addison＇ s disease was administrated with glucocorticoid and rifampicin simultaneously, but the symptom didn＇ t relieve at the physiological dose of glucocorticoid, and his adrenal hormone replacement therapy regimen was prednisone 5 mg in the morning, hexadecadrol 0.375 mg and fludrocortisones 0.1 mg in the afternoon. 2 months later, his 8 ： 00 ACTH was 〉 275 pmolW·L^-1, cortisol was 44.41 nmol·L^-1, and his hypodynamia symptom was relieved, but skin pigmentation didn＇ t lessen obviously, which showed glucocorticoid dosage was insufficient.
出处
《中国药物应用与监测》
CAS
2010年第1期49-51,共3页
Chinese Journal of Drug Application and Monitoring
