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·药学服务·


          英夫利西单抗致溃疡性结肠炎合并强直性脊柱炎患者脓疱型银

          屑病的药学监护
                                   Δ

                                                      1 #
          妥小玲    1, 2* ,王 钊 ,巨世杰 ,杨少奇 ,马丽娟 (1.宁夏医科大学总医院药剂科,银川 750004;2.宁夏医科
                            3
                                              5
                                    1, 4
          大学药学院,银川 750004;3.北京大学第一医院宁夏妇女儿童医院药剂科,银川 750001;4.银川市良田镇卫
          生院,银川 750001;5.宁夏医科大学总医院消化内科,银川 750004)

          中图分类号  R969.3      文献标志码  A      文章编号  1001-0408(2025)18-2312-05
          DOI  10.6039/j.issn.1001-0408.2025.18.17

          摘   要  目的  为使用英夫利西单抗后出现脓疱型银屑病的溃疡性结肠炎(UC)合并强直性脊柱炎(AS)患者的药学监护提供参
          考。方法  临床药师参与1例UC合并AS患者在使用英夫利西单抗后出现脓疱型银屑病的诊疗过程。临床药师通过Naranjo’s评
          估量表判断患者发生的脓疱型银屑病与英夫利西单抗的相关性为“很可能”。针对患者使用英夫利西单抗后出现的脓疱型银屑
          病,建议停用英夫利西单抗,改用乌帕替尼缓释片;针对患者使用乌帕替尼后出现的皮肤过敏反应,临床药师建议继续使用乌帕替
          尼,并密切监测患者在治疗期间可能出现的不良反应。结果  医师采纳临床药师建议。经治疗后,患者病情好转,准予带药出院;
          出院后随访显示治疗有效、可耐受。结论  临床药师分析了英夫利西单抗与脓疱型银屑病的因果关系,通过皮损动态监测、治疗反
          应评估、药物方案优化等药学服务手段,协助医师制定个体化用药方案,保障了患者用药的安全性和有效性。
          关键词  英夫利西单抗;药学监护;脓疱型银屑病;溃疡性结肠炎;强直性脊柱炎

          Pharmaceutical  care  for  a  ulcerative  colitis  and  ankylosing  spondylitis  patient  who  developed  pustular
          psoriasis induced by infliximab
          TUO Xiaoling ,WANG Zhao ,JU Shijie ,YANG Shaoqi ,MA Lijuan (1.  Dept.  of  Pharmacy,  General
                                      3
                       1, 2
                                                                              1
                                                                  5
                                                 1, 4
          Hospital  of  Ningxia  Medical  University,  Yinchuan  750004,  China;2.  School  of  Pharmacy,  Ningxia  Medical
          University, Yinchuan  750004,  China;3.  Dept.  of  Pharmacy,  Ningxia  Women  and  Children’s  Hospital,  Peking
          University  First  Hospital,  Yinchuan  750001,  China;4.  Liangtian  Town  Health  Center  of  Yinchuan,  Yinchuan
          750001,  China;5.  Dept.  of  Gastroenterology,  General  Hospital  of  Ningxia  Medical  University,  Yinchuan
          750004, China)

          ABSTRACT    OBJECTIVE To provide a reference for pharmaceutical care in patients with ulcerative colitis (UC) and ankylosing
          spondylitis (AS)  who  developed  pustular  psoriasis  induced  by  infliximab.  METHODS  Clinical  pharmacists  participated  in  the
          pharmaceutical  care  process  of  a  patient  with  UC  and  AS  who  developed  pustular  psoriasis  after  using  infliximab.  The  clinical
          pharmacists  determined,  using  Naranjo’s  Scale,  that  the  correlation  between  the  patient’s  pustular  psoriasis  and  infliximab  was
         “likely”.  Regarding  the  patient’s  development  of  pustular  psoriasis  after  using  infliximab,  the  clinical  pharmacists  recommended
          discontinuing  infliximab  and  switching  to  Upadacitinib  extended-release  tablets.  For  the  patient’s  skin  allergic  reaction  after  using
          upadacitinib,  the  clinical  pharmacists  advised  continuing  the  use  of  upadacitinib  and  closely  monitoring  any  potential  adverse
          reactions  during  the  treatment  period.  RESULTS  The  clinicians  adopted  the  clinical  pharmacists’  recommendation.  Following  the
          treatment,  the  patient’s  symptoms  were  significantly  alleviated,  and  the  patient  was  discharged  with  medication.  The  follow-up
          after  discharge  showed  that  the  treatment  was  effective  and  well-tolerated.  CONCLUSIONS  The  clinical  pharmacists  analyzed  the
          causal relationship between infliximab and pustular psoriasis. Through pharmaceutical care measures such as dynamic monitoring of
          skin  lesions,  evaluation  of  treatment  responses,  and  optimization  of  drug  regimens,  they  assisted  the  physicians  in  formulating  an
                                                              individualized  medication  plan,  ensuring  the  safety  and
              Δ 基金项目 宁夏自然科学基金项目(No.2022AAC03484)
             * 第一作者 硕 士 研 究 生 。 研 究 方 向 :临 床 药 学 。 E-mail:    efficacy of the patient’s medication use.
          3190567966@qq.com                                   KEYWORDS    infliximab;  pharmaceutical  care;  pustular
              # 通信作者 主管药师,硕士。研究方向:临床药学。E-mail:                psoriasis; ulcerative colitis; ankylosing spondylitis
          635382555@qq.com


          · 2312 ·    China Pharmacy  2025 Vol. 36  No. 18                            中国药房  2025年第36卷第18期
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