Pharmaceutical Practice of One Case of Severe Hypokalemia Induced by Glucocorticoid in Patient with Minimal Change Nephropathy

Abstract

Abstract: Objective To introduce the pharmaceutical practice in a minimal change nephropathy patient with severe hypokalemia induced by glucocorticoid in clinical setting. Methods For a specific case, the clinical pharmacists participated in the individualized design of immunosuppressive therapy for a patient with glucocorticoid-induced hypokalemia, and put forward suggestions for pharmaceutical intervention to ensure safe and effective medication for patients. Results Clinical pharmacists participated in deciding the treatment and strengthened pharmaceutical care by playing their strengths, thus the therapeutic effect of the patient was ensured. Conclusion The safety, effectiveness and rationality of the drug use can be improved by strengthening the pharmaceutical care for minimal change nephropathy patients with severe hypokalemia induced by glucocorticoids.

Key words: clinical pharmacist, glucocorticoid, hypokalemia, minimal change disease

CLC Number:

R977.1

YANG Hong, YIN Donghong. Pharmaceutical Practice of One Case of Severe Hypokalemia Induced by Glucocorticoid in Patient with Minimal Change Nephropathy[J]. Chinese Journal of Pharmacovigilance, 2019, 16(7): 425-429.

References

[1] Vivarelli M,Massella L,Ruggiero B,et.al. Minimal Change Disease[J]. Clin J Am SocNephrol. 2017,12(2):332-345.
[2] Rovin B H,Caster D J,Cattran D C,et al.Management and treatment of glomerular diseases (part 2): conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference[J].Kidney Int, 2019,95(2):281-295.
[3] Korbet S M,Whittier W L.Management of Adult Minimal Change Disease[J]. Clinical Journal of the American Society of Nephrology,2019,14(6):911-913.
[4] Cattran D C,Feehally J,Cook H T,et al.Kidney Disease Improving Global Outcomes Glomerulonephritis Work Group: KDIGO clinical practice guideline for glomerulon-
phritis[J]. Kidney International Supplements,2012, 2(2): 139-274.
[5] Hogan J,Radhakrishnan J.The treatment of minimal change disease in adults[J]. J Am Soc Nephrol,2013,24(5): 702-711.
[6] Palmer S C,Nand K,Strippoli G F M. Interventions for minimal change disease in adults with nephrotic syndrome[J]. Cochrane Database Syst Rev, 2008,(1):2-10.
[7] Hwang Y G,Saag K.The safety of low-dose glucocorticoids in rheumatic diseases: results from observational studies[J]. Neuroimmunomodulation,2015,22(1-2):72-82.
[8] Ke Q,He F,Lu L,et al.The R900S mutation in CACNA1S associated with hypokalemic periodic paralysis[J]. Neuro-
muscul Disord,2015,25(12):955-957.
[9] Finsterer J.Primary periodic paralyses[J]. Acta Neurol Scand, 2008,117(3):145-158.
[10] Lin S H,Huang C L.Mechanism of thyrotoxic periodic paralysis[J]. Journal of the American Society of Nephrology, 2012, 23(6):985-988.
[11] Arzel-Hézode M,McGoey S,Sternberg D,et al.Glucocorticoids may trigger attacks in several types of periodic paralysis[J].Neuromuscul disord,2009,19(3): 217-219.
[12] Poulin H,Gosselin-Badaroudine P,Vicart S,et al.Substitutions of the S4DIV R2 residue (R1451) in Na V 1.4 lead to complex forms of paramyotonia congenita and periodic paralyses[J]. Sci Rep, 2018 ,8(1):2041.
[13] 王兆平, 高峰, 刘洁一,等.糖皮质激素低钾性麻痹与原发性低钾性麻痹比较研究[J].河北医药, 2015, 37(6):877-879.
[14] Levitt J O.Practical aspects in the management of hypokalemic periodic paralysis[J]. Journal of translational medicine, 2008,6(1):1-8.
[15] Weber F, Jurkat-Rott K, Lehmann-Horn F. Hyperkalemic periodic paralysis[J/OL].(2003-07-18)[2016-01-28]. https://www.ncbi.nlm.nih.gov/books/NBK1496/.
[16] Kasper D,Fauci A,Hauser S,el al. Harrison's Principles of Internal Medicine[M]. 19th ed. New York: McGraw-
Hill Education,2015.
[17] Teagarden C M, Picardo C W.Betamethasone-induced hypokalemic periodic paralysis in pregnancy[J]. Obstetrics & Gynecology, 2011, 117(2): 433-435.
[18] Lapie P,Lory P,Fontaine B.Hypokalemic periodic paralysis: an autosomal dominant muscle disorder caused by mutations in a voltage-gated calcium channel[J]. Neurom-
uscul Disord, 1997,7(4):234-400.
[19] Lewis K L,Malouff T D,Kesler A M,el al. Hypokalemic Periodic Paralysis- the importance of patient education[J]. Rom J Intern Med ,2019,(1):1-8.
[20] 陈瑶. 泼尼松致30例不良反应文献分析[J].中国药物警戒,2010,7(10):626-628.
[21] 张凯, 童荣, 倪娟, 等.1次静滴地塞米松诱发低钾性麻痹例[J].西南国防医药,2017,27(8):898-898.
[22] 钟林清, 许名远, 许慈萱, 等.宁德地区低钾型周期性麻痹152例诱因分析[J].中国实用医药, 2015, 10(8):114-115.
[23] 司继刚. 地塞米松注射液临床应用安全性分析评价[J]. 中国药学杂志,2016,51(22):1972-1975.
[24] 李志金, 杨赞章, 李善学.甲泼尼龙致低钾性麻痹2例[J].医药导报, 2015,34(8):1117-1118.
[25] 张永兰, 程岩, 王桂萍, 等.突发性聋患者口服甲泼尼龙致低钾麻痹一例[J].中华耳鼻咽喉头颈外科杂志, 2016, 51(10):783-784.
[26] 李群,胡怀岭,刘尚,等.低钾血症118 例心电图分析[J]. 岭南急诊医学杂志,2014,19(3): 220-221.