Clinical pharmacist's intervention in a case of drug-induced oxidative hemolytic anemia resulting from the combined use of aspirin and atorvastatin
Objective The clinical pharmacist analyzes the clinical manifestations and mechanisms of drug-induced oxidative hemolytic anemia caused by the combined use of aspirin and atorvastatin,exploring the surveillance strategies during the development of hemolytic anemia and the role a clinical pharmacist can play in the clinical treatment process.Methods The clinical pharmacist conducted a deep analysis of an actual case and utilized the Naranjo Adverse Drug Reaction Probability Scale to evaluate the association.Additionally,synthesized literature data from databases such as China National Knowledge Infrastructure(CNKI),Wanfang Data,PubMed,and Embase to summarize the characteristics,pathogenesis,latency period,management strategies,and outcomes of this type of adverse reaction.Results In one case of hemolytic anemia,the clinical phar-macist observed red blood cell destruction and compensatory bone marrow hyperplasia,and confirmed the potential risk associated with dual-drug therapy.Literature research further revealed the dynamic changes pattern of RDW,and combined this with the therapeutic outcome in the present case,it confirmed that the co-administration of these two drugs may influence the expression of inflammatory factors and potentially participate in the pathogenesis of DOHA(Drug-Induced Oxidative Hemolytic Anemia).Conclusion Clinical pharmacists play a pivotal role in identifying and managing rare DOHA adverse reactions caused by the combined use of aspirin and atorvastatin,particularly for cases that appear shortly after drug initiation and resolve rapidly upon discontinuation.When encountering such events,pharmacists should advise on immediate cessation of the medi-cation and arrange for comprehensive laboratory tests,including complete blood count,urine routine,liver function tests,and reticulocyte counts,and consider G6PD gene testing is also recommended for personalized treatment planning.Moreover,reinforcing patient education about medication use in G6PD-deficient patients and regularly monitoring related biomarkers are critical measures to ensure safe drug use among high-risk patients.
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