1例来那度胺致心动过缓患者的药学监护  

Pharmaceutical Care for a Patient with Bradycardia Induced by Lenalidomide

作　　者：田稷馨 苗文娟 廖应熙 章萍 王晓丹 李姗 严海泓 TIAN Jixin;MIAO Wenjuan;LIAO Yingxi;ZHANG Ping;WANG Xiaodan;LI Shan;YAN Haihong(Department of Pharmacy,Institute of Hematology and Blood Diseases Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Tianjin 300020,China)

机构地区：[1]中国医学科学院血液病医院(中国医学科学院血液学研究所),实验血液学国家重点实验室,国家血液系统疾病临床医学研究中心,药剂科,天津300020

出　　处：《中国药物警戒》2020年第8期487-490,495,共5页Chinese Journal of Pharmacovigilance

基　　金：重大新药创制重大专项(2017ZX09304024)。

摘　　要：目的探讨来那度胺致心动过缓的药学监护,促进合理用药。方法回顾性分析临床药师参与1例滤泡性淋巴瘤患者使用来那度胺化疗后继发心动过缓的治疗过程,通过协助临床医师制定个体化治疗方案,对主要药物治疗实施药学监护。结果临床药师分析患者发生心动过缓的原因,并从患者治疗方案的选择、合并用药的调整等方面为医师提供合理化用药建议并被采纳,取得了很好的疗效。结论来那度胺心脏不良反应与其临床应用有明显的时间相关性。患者在使用来那度胺过程中如出现心律不齐症状时,临床药师及医师应结合病史、用药史仔细分析,及早诊断和治疗,从而降低患者不良反应危害、改善患者预后。Objective To explore the pharmaceutical care for a patient with bradycardia induced by lenalidomide in order to promote the rational use of the drug. Methods A retrospective analysis was conducted of the pharmaceutical care involving clinical pharmacists for a patient with follicular lymphoma, who experienced secondary bradycardia after chemotherapy with lenalidomide. Clinical pharmacists assisted physicians in developing an individualized therapeutic regimen and practiced special pharmaceutical care in the drug therapy. Results Clinical pharmacists analyzed the causes of this case of bradycardia, and gave advice to physicians about how to select therapeutic regimens and adjust concomitant medications, which was taken and achieved very good curative effect. Conclusion There is a significant correlation between the occurrence of bradycardia and the time lenalidomide is administered. If symptoms of arrhythmia occur during the use of lenalidomide, clinical pharmacists and physicians should carefully analyze the medical and medication history to initiate early diagnosis and treatment so as to reduce the harm of adverse drug reactions and lead to a better prognosis.

关 键 词：来那度胺 心动过缓 药学监护 滤泡性淋巴瘤 

分 类 号：R994.11[医药卫生—毒理学]