Clinical pharmacists participated in the treatment process of a case of pancreatitis caused by dulaglutide. The patient was a 50-year-old male, suffered  from type 2 diabetes, hypertension and cerebral infarction for many years. Due to sudden abdominal pain and abdominal distention, he was admitted to the hospital and diagnosed as acute pancreatitis according to the laboratory examination results. Clinical pharmacists analyzed the patient's past disease history and medication history, evaluated the possibility of dulaglutide causing pancreatitis. Clinical pharmacists suggested to stop taking dulaglutide at once. At the same time, the treatment of octreotide and fasting were gived. The patient's lipase gradually decreased to the normal value, and abdominal pain and abdominal distension improved. The clinical pharmacist analyzed the relationship between drug use and adverse drug reaction based on the patient's condition and medication, adjusted the medication plan in time, and strengthened the understanding of drug-induced diseases.

1.Goldenberg RM, Steen O. Semaglutide: review and place in therapy for adults with type 2 diabetes[J]. Can J Diabetes, 2019, 43(2): 136-145. DOI: 10.1016/j.jcjd.2018.05.008.

2.Marso SP, Holst AG, Vilsbøll T. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes[J]. N Engl J Med, 2017, 376(9): 891-892. DOI: 10.1056/NEJMc1615712.

3.中华医学会糖尿病学分会.中国2型糖尿病防治指南（2020年版）[J]. 中华糖尿病杂志, 2021, 13(4): 315-409. DOI: 10.3760/cma.j.cn311282-20210304-00142.

4.郑晓辉, 宋轶萱, 史桂玲, 等. 度拉糖肽治疗2型糖尿病的临床研究进展[J].现代药物与临床, 2020, 35(1): 184-188. [Zheng XH, Song YX, Shi GL, et al. Research progress on clinical research of dulaglutide in treatment of type 2 diabetes[J], Drugs & Clinic, 2020, 35(1): 184-188.] DOI: 10.7501/j.issn.1674-5515.2020.01.038.

5.黄园园, 龚攀, 田力. 急性重症胰腺炎[J]. 医学新知, 2023, 33(4): 309-316. [Huang YY, Gong P, Tian L. Severe acute pancreatitis[J]. New Medicine, 2023, 33(4): 309-316.] DOI: 10.12173/j.issn.1004-5511.202303023.

6.中华医学会外科学分会胰腺外科学组.中国急性胰腺炎诊治指南(2021)[J].浙江实用医学, 2021, 26(6): 511-519, 535. DOI: 10.16794/j.cnki.cn33-1207/r.2021.06.003.

7.杨华, 魏金, 王嘉仡, 等. 药品不良反应/事件报告评价方法研究[J]. 中国药物警戒, 2009, 6(10): 581-584. [Yang H, Wei J, Wang JY, et al. Study on methods of adverse drug reaction/event reporting assessment[J]. Chinese Journal of Pharmacovigilance, 2009, 6(10): 581-584.] DOI: 10.3969/j.issn.1672-8629.2009.10.002.

8.张佳斌. GLP-1(胰高血糖素样肽-1)的安全性与不良反应[J].中西医结合心血管病电子杂志, 2020, 8(31): 30, 32. [Zhang JB. Safety and adverse reactions of GLP-1 (Glucagon-like peptide-1)[J].Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine, 2020, 8(31): 30, 32.] DOI: 10.16282/j.cnki.cn11-9336/r.2020.31.021.

9.纪立农,邹大进,洪天配,等.GLP-1受体激动剂临床应用专家指导意见[J].中国糖尿病杂志, 2018, 26(5): 353-361. [Ji LN, Zou DJ, Hong TP, et al. Expert guidance on the clinical application of GLP-1 receptor agonists[J]. Chinese Journal of Diabetes, 2018, 26(5): 353-361.] DOI: 10.3969/j.issn.1006-6187.2018.05.001.

10.Singh S, Chang HY, Richards TM, et al. Glucagon like peptide 1-based therapies and risk of hospitalization for acute pancreatitis in type 2 diabetes mellitus: a population-based matched case-control study[J]. JAMA Intern Med, 2013, 173(7): 534-539. DOI: 10.1001/jamainternmed. 2013.2720.

11.李琳,李全民.胰高糖素样肽-1受体激动剂周制剂的中国证据[J]. 药品评价, 2020, 17(S1): 33-37. [Li L, Li QM. Evidence from China for the weekly preparation of glucagon like peptide-1 receptor agonists[J]. Drug Evaluation, 2020, 17(S1): 33-37.] DOI: 10.3969/j.issn.1672-2809.2020.z1.007.

12.彭湾湾, 钟雯, 薛君力, 等. 聚乙二醇洛塞那肽注射液对早期2型糖尿病肾病患者的肾脏保护作用[J]. 实用医学杂志, 2020, 36(18): 2495-2499. [Peng WW, Zhong W, Xue JL, et al. Role of PEX168 injection in renal protection of patients with earlier type 2 diabetic kidney disease[J]. Journal of Practical Medicine, 2020, 36(18): 2495-2499.] DOI: 10.3969/j.issn.1006-5725.2020. 18.008.

13.刘玉玲,郑淑芬,钟诗龙. 基于FDA不良事件报告系统度拉糖肽安全信号的检测与分析[J]. 中国医院药学杂志, 2021, 41(22): 2328-2333. [Liu YL, Zheng SF, Zhong SL. Detections and evaluations of adverse drug reaction signals of trulicity based upon FDA adverse event reporting system[J]. Chinese Journal of Hospital Pharmacy, 2021, 41(22): 2328-2333.] DOI: 10.13286/j.1001-5213. 2021.22.10.

14.Emoto M, Oura T, Matsui A, et al.Pancreatic safety in Japanese patients with type2 diabetes treated with once weekly dulaglutide 0.75 mg up to 52 weeks in phase 3 clinical trials[J]. Endocr J, 2017, 64(2): 191-206. DOI: 10.1507/endocrj.EJ16-0365.

15.Butler AE, Campbell-Thompson M, Gurlo T, et al. Marked expansion of exocrine and endocrine pancreas with incretin therapy in humans with increased exocrine pancreas dysplasia and the potential for glucagon-producing neuroendocrine tumors[J]. Diabetes, 2013, 62(7): 2595-2604. DOI: 10.2337/db12-1686.

16.刘小琴, 陈园. 脂源性急性胰腺炎糖脂代谢紊乱特点及临床意义分析[J]. 数理医药学杂志, 2022, 35(12): 1802-1805. [Liu XQ, Chen Y. Characteristics and clinical significance of glucose and lipid metabolism disorders in lipid induced acute pancreatitis[J]. Journal of Mathematical Medicine, 2022, 35(12): 1802-1805.] DOI: 10.3969/j.issn.1004-4337.2022.12.018.

17.Noel RA, Braun DK, Patterson RE, et al. Increased risk of acute pancreatitis and biliary disease observed in patients with type 2 diabetes: a retrospective,cohort study[J].Diabetes Care, 2009, 32(5: 834-838. DOI: 10.2337/dc08-1755.

18.Babajide O, K CN, Solaimanzadeh I, et al. Case report of acute pancreatitis associated with combination treatment of dulaglutide and glipizide[J]. Cureus, 2022, 14(1): e20938. DOI: 10.7759/cureus.20938.