Pharmaceutical practice of one case of severe liver injury caused by enoxaparin due to renal injury caused by iodomepral

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Author: Qiang YANG ^# Shuang LIU ^# Jia-Li MI  Peng ZHANG

Affiliation: Department of Pharmacy, Suining Central Hospital, Suining 629000, Sichuan Province, China #Co-first author: Qiang YANG and Shuang LIU

Keywords: Iodomepral Renal injury Enoxaparin Liver injury Pharmaceutical care

DOI: 10.19960/j.issn.1005-0698.202307014

Reference: Qiang YANG, Shuang LIU, Jia-Li MI, Peng ZHANG.Pharmaceutical practice of one case of severe liver injury caused by enoxaparin due to renal injury caused by iodomepral[J].Yaowu Liuxingbingxue Zazhi,2023, 32(7):836-840.DOI: 10.19960/j.issn.1005-0698.202307014.[Article in Chinese]  Copied

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Abstract

A 67-year-old man with lung adenocarcinoma complicated with heart failure developed acute kidney injury (Scr 149 μmol·L^-1, BUN 13.23 mmol·L^-1, UA 439 μmol·L^-1) and severe liver injury (ALT 592 U·L^-1, AST 782 U·L^-1, γ-GGT 121 U·L^-1). By medication analysis, the pharmacist considered that iodomepral most probably induced acute renal injury, which then led to the accumulation of enoxaparin in the body and caused severe liver injury. The pharmacist advised doctor to monitor the changes of renal function, withdrawal enoxaparin sodium and discontinue almonertinib mesylate. Then, the liver and renal functions returned to normal. This case indicates that contrast induced nephropathy may occur in patients with high-risk after the use of contrast agents, and may further lead to accumulation of other medication. Pharmacists should provide pharmaceutical mon-itoring, medication analysis and sufficient clinical evaluation to assist doctors in adjusting treatment scheme for such patients.

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References

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