临床药师参与1例直肠癌mFOLFOX6化疗致血氨升高病例的治疗体会  

Experience of the Clinical Pharmacist in the Treatment of a Case of Rectal Cancer with Elevated Blood Ammonia Caused by mFOLFOX6 Chemotherapy

作　　者：倪晨旭 谢文 王辉[2] 许青[2] 沈甫明 Ni Chenxu;Xie Wen;Wang Hui;Xu Qing;Shen Fuming(Department of Pharmacy,Shanghai Tenth People’s Hospital,Tongji University School of Medicine,Shanghai 200072,China;Department of Oncology,Shanghai Tenth People’s Hospital,Tongji University School of Medicine,Shanghai 200072,China)

机构地区：[1]同济大学附属第十人民医院药学部,上海200072 [2]同济大学附属第十人民医院肿瘤内科,上海200072

出　　处：《药物流行病学杂志》2020年第1期48-51,共4页Chinese Journal of Pharmacoepidemiology

基　　金：2018年上海市临床药学重点专科建设项目(编号:2018-20201);同济大学附属第十人民医院“国自然院内培养计划”资助项目(编号:0403.17.046)。

摘　　要：本文报道1例直肠癌患者行mFOLFOX6[奥沙利铂+5-氟尿嘧啶(5-FU)]化疗后出现神志模糊,反应迟钝,恶心呕吐,急查肝功能正常,头颅CT平扫未见明显异常,而血氨升高。临床药师对患者的不良反应进行分析判断,并给予药学监护。考虑患者血氨升高与化疗药物代谢有关,予以5-FU减量,调整奥沙利铂滴速,降血氨治疗后,患者血氨基本恢复正常。临床药师参与化疗药物药学监护,有利于保障肿瘤患者用药安全,提高临床药物治疗水平。This paper reports the case of a rectal cancer patient who underwent mFOLFOX6(oxaliplatin + 5-FU) chemotherapy and presented with blurred mind, slow reaction, nausea and vomiting. His liver function was normal and no abnormality was found on CT plain scan, but his blood ammonia elevated. The clinical pharmacist analyzed and judged the adverse reactions of the patient, and carried out pharmaceutical care. Considering that the elevation of blood ammonia is related to the metabolism of chemotherapeutic drugs, a series of measures was carried out. After the reduction of dose of 5-FU, the adjustment of dropping rate of oxaliplatin and the treatment of reducing blood ammonia, the level of blood aminogen returned to normal. The participation of the clinical pharmacist in pharmaceutical care of chemotherapeutic drugs is conducive to ensuring the safety of drug use of cancer patients and improving the level of clinical drug treatment.

关 键 词：直肠癌 mFOLFOX6化疗方案 血氨升高 药品不良反应 药学监护 

分 类 号：R97[医药卫生—药品]