RESUMO
OBJECTIVE:To explore the role of clinical pharmacists in the clinical nutrition therapy for patients with parenteral nutrition-associated liver dagame (PNALD),and to promote the rational use of nutrition drugs. METHODS:Clinical pharmacists participated in the treatment of a case of PNALD,and suggested adjusting 5% Glucose and sodium chloride injection 500 mL to 0.9% Sodium chloride injection 500 mL,30% Long-chain triglycerides 250 mL to 20% Medium/long chain fatty emulsion 250 mL,8.5% Compound amino acid injection(18 AA)1000 mL to 8% Compound amino acid injection(15 AA)750 mL;addition-ally using 20%Alanyl glutamine injection 100 mL and 10% ω-3 Fish oil fat emulsion injection 100 mL inall in oneparenteral nutrition(PN)formula. The remaining recipes remain unchanged. Reduced glutathione and S-methionine were also adopted for pro-tecting liver and receding jaundice,and the amount of PN was decreased gradually and replaced by enteral nutrition (EN). RE-SULTS:Physicians adopted the suggestions of clinical pharmacists,and liver function of the patient recovered to normal. CON-CLUSIONS:Main factors of PNALD include medication time of PN,types and intake of lipid,over nutrition. Clinical pharmacists provide pharmaceutical care in nutritional treatment for patients,which can assure effective and safe use of nutritional drugs,and reduce the occurrence of complication and ADR.
