中国药物警戒 ›› 2024, Vol. 21 ›› Issue (8): 936-938.
DOI: 10.19803/j.1672-8629.20230760

• 安全与合理用药 • 上一篇    下一篇

1例利培酮致高泌乳素血症患者的药学监护

张乾, 恽渊, 何恋*   

  1. 贵州省第二人民医院药剂科临床药学室,贵州 贵阳 550004
  • 收稿日期:2023-12-05 出版日期:2024-08-15 发布日期:2024-08-21
  • 通讯作者: *何恋,女,硕士,主管药师,临床药学。E-mail: 714237545@qq.com
  • 作者简介:张乾,男,本科,副主任药师,临床药学。

Pharmaceutical care of hyperprolactinemia in a patient induced by risperidone

ZHANG Qian, YUN Yuan, HE Lian*   

  1. Department of Pharmacy, the Second People’s Hospital of Guizhou Province, Guiyang Guizhou 550004, China
  • Received:2023-12-05 Online:2024-08-15 Published:2024-08-21

摘要: 目的 分析服用利培酮导致高泌乳素血症的病例,为临床安全、合理用药提供参考。方法 对 1 例服用利培酮导致高泌乳素血症进行个体化治疗方案调整、药学监护、用药宣教,并结合相关文献,总结高泌乳素血症的临床表现、产生机制、不良结果、治疗方案及药学监护要点。结果 本例为伴有精神病性症状的重度抑郁发作患者,服用利培酮治疗精神疾病的第17天出现溢乳、月经紊乱、血清泌乳素水平升高;通过联用阿立哌唑治疗,患者的血清泌乳素水平逐渐下降,溢乳消失。结论 抗精神病药物导致的高泌乳血症不良反应存在羞耻感和隐蔽性,用药期间应加强患者的监护、用药宣教,定期检查血清泌乳素水平,做到早识别、早调整治疗方案。

关键词: 利培酮, 阿立哌唑, 高泌乳素血症, 药品不良反应, 临床药师, 药学监护

Abstract: Objective To analyze a case of hyperprolactinemia caused by the use of risperidone, so as to provide reference for clinical safety and rational medication. Methods In a case of hyperprolactinemia caused on by risperidone use, individualized treatment plan adjustment, pharmacological monitoring, and medication education were carried out, and relevant literature was combined to summarize the clinical manifestations, mechanisms, adverse outcomes, treatment plans, and key points of pharmaceutical monitoring of hyperprolactinemia. Results This case is a patient with severe depressive episodes accompanied by psychotic symptoms. The patient suffered lactation, menstrual problems, and elevated serum prolactin levels on the 17th day of therapy with risperidone for mental illness; however, with the combination of aripiprazole treatment, the patient’s serum prolactin level gradually decreases and the nipple discharge disappears. Conclusion The adverse reaction of hyperprolactinemia caused by antipsychotic drugs have a sense of shame and concealment. During medication, patient monitoring and medication education should be strengthened, and serum prolactin levels should be regularly checked to achieve early identification and adjustment of treatment plans.

Key words: risperidone, aripiprazole, hyperprolactinemia, adverse drug reaction, clinical pharmacist, pharmaceutical monitoring

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