1例培美曲塞联合卡铂治疗老年非小细胞肺癌患者的药学监护  

Pharmaceutical care on the elderly patients of pemetrexed combined with carboplatin with non-small cell lung cancer

作　　者：杨珺[1] 陈喆[1] 贺飞[1] 朱志祥[1] 周海燕[1] 李国辉[1] YANG Jun CHEN Zhe HE Fei ZHU Zhi-xiang ZHOU Hai-yan LI Guo-hui(Department of Pharmacy, National Cancer centre~Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100021, China)

机构地区：[1]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院药剂科,北京100021

出　　处：《临床药物治疗杂志》2017年第3期52-55,共4页Clinical Medication Journal

摘　　要：目的:探讨老年非小细胞肺癌患者化疗期间的药学监护策略。方法:通过老年非小细胞肺癌患者化疗期间化疗药物选择、剂量调整及镇痛药物选择,结合临床指南及治疗进展,分析老年肺癌患者使用培美曲塞与卡铂两药方案的药学监护重点。结果:对于使用培美曲塞与铂类联合化疗的非小细胞肺癌老年患者,卡铂具有更好的临床耐受性,由于铂类药物的肾毒性及培美曲塞肾排泄的特点,采用此方案的老年患者应严密监测肾功的变化,并结合患者生理状态、转移部位对化疗药物剂量进行调整;对老年人合用药物(抗凝、降脂、镇痛)与化疗药物的相互作用给予更多的药学监护,提高患者化疗的依从性,预防与降低毒性反应,最终使老年患者获益。结论:临床药师参与老年非小细胞肺癌患者的临床治疗实践,有利于制定个体化给药方案,提高患者药物治疗的依从性。Objective： To probe into the operation and management of pharmaceutical care on the elderly patients with non-small cell lung cancer. Methods： By adjusting the chemotherapy drug dosage and analgesia drug, combined with the clinical guidelines, clinical pharmacist can summarize the main points of pharmaceutical care of elderly patient with NSCLC. Results： The elderly patients of have better clinical tolerance with carboplatin, and should be monitored the renal function because of the nephrotoxicity of platinum and renal excretion of pemetrexed; pharmacist can adjust the dose of chemotherapy combination drugs（anticoagulant, lipid-lowering drug, analgesia） in order to improve patients＇ compliance with chemotherapy, and reduce the adverse drug reaction. Conclusion： With the pharmacists＇ participating in clinical chemotherapy of elderly NSCLC patients, it was to formulate individualized dosage regimen, and improve the patient＇s medication compliance and quality of life.

关 键 词：老年患者 非小细胞肺癌 培美曲塞 卡铂 药学监护 

分 类 号：R969[医药卫生—药理学]