临床药师在厄罗替尼致间质性肺炎患者药物治疗中的作用  

Role of Clinical Pharmacists in Therapy for Patient with Interstitial Lung Disease Induced by Erlotinib

作　　者：李义秀[1] 娄艳[2] 章新晶[1] 熊爱珍[1] 

机构地区：[1]南昌大学第二附属医院药剂科,南昌330006 [2]南方医科大学南方医院药剂科,广州510515

出　　处：《中国药房》2016年第17期2431-2433,共3页China Pharmacy

摘　　要：目的:探讨临床药师在厄罗替尼致间质性肺炎(ILD)患者药物治疗中的作用。方法:临床药师参与1例肺癌患者胸、腰椎放疗后续厄罗替尼靶向治疗中出现ILD的药物治疗,分析ILD的发生原因,并根据患者实验室检查指标和症状先后建议停用亚胺培南西司他丁钠、氟康唑、厄罗替尼;停用甲基强的松龙,改予泼尼松30 mg,po,qd抗炎;调整泼尼松剂量至40 mg/d,加用羧甲司坦口服液10 ml,tid改善呼吸道症状;将哌拉西林钠舒巴坦钠改为帕尼培南倍他米隆1 g,ivgtt,bid。结果:医师采纳临床药师建议,患者气促、双肺炎症好转,出院带药方案为厄罗替尼150 mg,po,qd。结论:有既往放疗史的患者使用厄罗替尼易发生ILD,临床应用需谨慎。临床药师参与药物治疗,促进了临床安全、合理的用药。OBJECTIVE：To explore the role of clinical pharmacists in therapy for patient with interstitial lung disease（ILD）induced by erlotinib. METHODS：Clinical pharmacists participated in the therapy for ILD in a patient receiving erlotinib target treatment after thoracic vertebra and lumbar radiation,analyzed the cause of ILD and suggested to stop taking imipenem and cilastatin sodium,fluconazol and erlotinib according to lab indexes and patient＇s symptom;took prednisone 30 mg,po,qd,for anti-inflammation instead of methylprednisolone;adjusted the dose of prednisone to 40 mg/d,and additionally took Carbocisteine oral solution10 ml,tid,for improving respiratory symptom;panipenem betamipron 1 g,ivgtt,bid,instead of piperacillin sodium and sulbactam sodium. RESULTS：Physicians adopted the suggestions of clinical pharmacists,and the symptom of anhelation and double pneumonia recovered;discharged medication plan was erlotinib 150 mg,po,qd. CONCLUSIONS：The patient with radiation history easily suffers from ILD when using erlotinib,and should use erlotinib carefully in the clinic. Clinical pharmacists participated in drug therapy and promote safe and rational use of drugs in the clinic.

关 键 词：厄罗替尼 间质性肺炎 放疗 临床药师 

分 类 号：R734.2[医药卫生—肿瘤]