肺癌化疗出现严重药品不良反应的用药合理性分析  

Analysis of Rational Drug Use in Severe Adverse Drug Reaction Cases during Lung Cancer Chemotherapy

作　　者：王晓辉[1] 吴斌[2] 赵东 江银铃[4] 朱珺[1] 

机构地区：[1]上海交通大学医学院附属胸科医院药剂科,上海市200030 [2]上海交通大学医学院附属仁济医院药剂科,上海市200001 [3]山东潍坊市坊子区人民医院外一科,潍坊市261200 [4]上海交通大学医学院附属胸科医院肺内科,上海市200030

出　　处：《中国药房》2011年第18期1708-1711,共4页China Pharmacy

基　　金：上海高校选拨培养优秀教师青年教师科研专项基金(jdy08033)

摘　　要：目的:了解并分析住院肺癌患者化疗期间出现严重药品不良反应(ADR)的用药情况。方法:对2006年6月-2010年9月我院132例住院肺癌患者化疗期间出现严重ADR病例的化疗方案及合并用药数据进行统计和分析。结果:132例患者共住院化疗604人/次,严重ADR的发生率为39.57%(239人/次)。其中化疗方案的不合理应用主要发生于肝肾功能损伤患者化疗药物的选择上(63人/次);联合用药不当主要是化疗药物与联合应用药物存在毒性相加(205人/次),其次是经细胞色素P4503A4酶代谢的化疗药物与其抑制剂或诱导剂联用(180人/次)。结论:肺癌患者化疗期间的联合用药不合理现象普遍存在,临床医师必须全面了解合并应用的药物可能存在的相互作用和ADR,加强ADR监测,进一步促进肺癌化疗的合理用药。OBJECTIVE：To explore and analyze the drug use in lung cancer inpatients suffering severe adverse drug reactions （ADR） during chemotherapy.METHODS：A total of 132 lung cancer inpatients suffering severe ADR collected from our hospital from Jun.2006 to Sept.2010 were analyzed statistically in respect of chemotherapy regimens and drug combination.RESULTS：132 inpatients received chemotherapy for 604 times,and the incidence of severe ADR was 39.57% （239 cases）.The inappropriate choice of chemotherapy regimens for patients with liver or renal dysfunction mainly resulted from the selection of chemotherapeutic drugs （63 cases）.The irrational drug combination were mainly seen in combined toxicity between chemotherapeutic drugs and other drugs （205 cases）,followed by chemotherapy drugs which were mainly metabolized by the liver through cytochrome P4503A4 enzyme combined with inhibitor or revulsant（180 cases）.CONCLUSION：Inappropriate drug combination is quite common during chemotherapy.Clinical physicians should be familiar with ADR and drug interaction of drug combination.ADR monitoring should be strengthened to promote rational drug use during lung cancer chemotherapy.

关 键 词：肺癌化疗 严重药品不良反应 联合用药 

分 类 号：R969.3[医药卫生—药理学]