1例2型糖尿病患者使用抗抑郁药的药学监护.pdfVIP

1例2型糖尿病患者使用抗抑郁药的药学监护 汤智慧 朱曼 郭代红*（ 解放军总医院药品保障中心，北京 100853; ） [摘要] 目的：探讨糖尿病患者服用抗抑郁药物的药学监护内容。方法：临床药师通过 1 例 2 型糖尿病服用盐酸氟西汀后反复出现低血糖的病例，探讨低血糖发生的原因、抗抑郁药对 血糖的影响，以及临床药师对该类患者的药学监护切入点。结果：抗抑郁药物与不同受体亲 和力的差异，使得其对血糖的影响也不尽相同，临床药师可以将糖尿病患者应选择的抗抑郁 药品种及注意事项作为药学监护的切入点。结论：糖尿病患者应尽可能选择对血糖影响较小 的抗抑郁药，加强血糖监测，及时调整降糖药物可以有效地规避不良事件的发生。 [关键词]:糖尿病；抗抑郁药；临床药师；药学监护 Pharmaceutical care on a patient with type 2 diabetes taking antidepressants TANG Zhi-hui, ZHU,Man, GUO Dai-hong,. Department of Pharmaceutical Care, PLA General Hospital, Beijing 100853, China Corresponding author: GUO Dai-hong, Email：guodh301@ [Abstract] Objective: To investigate the content of pharmaceutical care in diabetic patients taking antidepressants. Methods: By analysing a case of hypolgycemia associated with fluoxetine use in a patient with type 2 diabetes t, clinical phamacist try to explore the reasons of hypoglycemia, the effect of antidepressant on blood glucose and the entry point of pharmaceutical care on diabetic patients taking antidepressants .Result:The differences of antidepressants with affinity for receptor make the effect of antidepressants on blood sugar are not the same. So pharmaceutical cares can give to the diabetic patients which is the preferred antidpressant and the caution when they taking antidepressants. Conclusion: Diabetic patients should try to select antidepressants having a smaller impact on blood sugar, monitor theblood glucose frequently and adjust the antidiabetic drugs timely to avoid the occurrence of adverse events. [Keywords]:Diabetes；Antidpreesants ；Clinical pharmacist；pharmaceutical cares; 糖尿病是常见的内分泌疾病，其发生不仅与生物学因素有关，也与心理、社会因素有关 糖尿病患者合并精神疾病的几率很高，常见的有抑郁症、焦虑症、进食障碍等，且往往容易 被人忽视，认为只是“情绪不佳”，只有当其发展严重、出现自残自杀现象时，才会开始重 视，不仅给患者带来了巨大的痛苦，另外抑郁、焦虑等症状均会引起血糖升高，不利于血糖 的控制，正确的诊断糖尿病患者是否具有抑郁症或焦虑症等并给予抗抑郁药物干预，从而改 善患者血糖，预防并发症。