关键词: 吲达帕胺, 中性粒细胞减少, 粒细胞缺乏症, 白细胞减少症, 临床药师, 药学监护, 药品不良反应

Abstract: Objective To explore the role of a clinical pharmacist in the treatment of a patient with agranulocytosis induced by indapamide via etiological analysis and pharmacological care. Methods One clinical pharmacist participated in the treatment of a patient with agranulocytosis. By analyzing medications used and using the Chinese Adverse Reaction Association Evaluation Methodand the Naranjo’s assessment scale, the pharmacist screened out indapamide as a possible drug that caused agranulocytosis from nine medications used. The pharmacist suggested withdrawing indapamide. The antihypertensive regimen was also optimized to switch to amlodipine and telmisartan. Results After withdrawal of indapamide, the patient’s neutrophil count returned to normal. Blood routine was monitored after discharge and no abnormality was found. The antihypertensive regimen was also improved by recommending a switch to amlodipine, and the patient was given medication instructions to avoid reuse of indapamide and reminded of the need for regular blood monitoring. Conclusion The clinical pharmacist played an important role in the clinical treatment by offering pharmaceutical care of a patient with agranulocytosis caused by indapamide, finding suspicious drugs in time, optimizing the treatment plan, and implementing individualized pharmaceutical care.

Key words: indapamide, neutropenia, agranulocytosis, leucopenia, clinical pharmacist, pharmaceutical care, adverse drug reaction