1例阴道恶性黑色素瘤免疫治疗的用药分析和药学监护  

Medication and Pharmaceutical Care for A Patient with Immunotherapy in Vaginal Malignant Melanoma

作　　者：刘阳 蒲兴祥 任志强[1] 刘英[1] 姚志红[1] 龚倩 Liu Yang;Pu Xingxiang;Ren Zhiqiang;Liu Ying;Yao Zhihong;Gong Qian(Department of Pharmacy,Yiyang Central Hospital,Yiyang 413000,Hunan,China;Department of Thoracic Medical OncologyⅡ,Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine,Central South University;Department of Pharmacy,Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine,Central South University)

机构地区：[1]益阳市中心医院药剂科,湖南益阳413000 [2]湖南省肿瘤医院/中南大学湘雅医学院附属肿瘤医院胸部内二科 [3]湖南省肿瘤医院/中南大学湘雅医学院附属肿瘤医院药学部

出　　处：《药物流行病学杂志》2020年第7期497-501,共5页Chinese Journal of Pharmacoepidemiology

摘　　要：黑色素瘤是一种特殊的皮肤癌,病死率在皮肤癌中居首。其治疗方式除了传统的手术治疗、放化疗外,还有靶向治疗和免疫治疗。本文报道临床药师参与1例晚期阴道恶性黑色素瘤患者抗肿瘤治疗方案的制定,协助医师及时、准确识别患者免疫治疗过程中出现的肝毒性及内分泌毒性反应,且对患者免疫治疗过程进行毒性管理、用药分析及药学监护,通过使用甲泼尼龙、还原型谷胱甘肽、复方甘草酸苷等对症处理,患者肝毒性降为1级遂开始行第3周期免疫检查点抑制药特瑞普利单抗的治疗;及时减轻了药物治疗过程中不良反应对患者的损害,提高了患者抗肿瘤治疗的依从性和耐受性,以期提高患者的生活质量和生存时间。Melanoma is a special type of skin cancer with the highest fatality rate among it.Treatment of melanoma include traditional surgery and chemoradiotherapy,also,targeted therapy and immunotherapy are available.This article for clinical pharmacist assists in physician developing anti-tumor therapeutic schedule1 for a patient with late vaginal malignant melanoma,assists in the timely and accurate identification for the occurrence of immunotherapy associated hepatotoxicity and endocrine toxicity reactions,practices the drug toxicity management,drug analysis and pharmaceutical care during the immunotherapy process,by using methylprednisolone sodium succinate,reduced glutathione,compound glycyrrhizin and other drugs for symptomatic treatment,the patient’s hepatotoxicity was reduced to grade 1 and treatment with third cycle immune checkpoint inhibitor namely toripalimab was used eventually.In this way,the damage on this patient caused by adverse reactions in drug treatment was alleviated timely,and the compliance and tolerance of anti-tumor treatment were improved,so as to improve the quality of life and prolong survival time of patients.

关 键 词：临床药师 阴道黑色素瘤 免疫治疗 药学监护 

分 类 号：R97[医药卫生—药品]