帕博利珠单抗致免疫性脑炎的药学监护  

Pharmaceutical Care of Pembrolizumab-induce Immune Encephalitis

作　　者：伍磊 龚建平[1] 向春红 杨娜[1] 李群[1] 杨瑞瑞 Wu Lei;Gong Jianping;Xiang Chunhong;Yang Na;Li Qun;Yang Ruirui(Department of Clinical Phamacy,the Second People's Hospital of Huaihua City,Huaihua 418000,Hunan,China;Department of Chest Oncology,the Second People's Hospital of Huaihua City,Huaihua 418000,Hunan,China)

机构地区：[1]怀化市第二人民医院临床药学科,湖南怀化418000 [2]怀化市第二人民医院胸部肿瘤内科,湖南怀化418000

出　　处：《药物流行病学杂志》2022年第9期636-639,共4页Chinese Journal of Pharmacoepidemiology

基　　金：湖南省卫生健康委一般资助课题(编号:202203104991)。

摘　　要：1例原发性非小细胞肺癌老年患者在使用帕博利珠单抗治疗过程中出现神志不清,胡言乱语,反应迟钝,临床药师结合患者病史、体检及诊疗情况,考虑免疫性脑炎,药品不良反应关联性评价分级为“很可能”,建议临床医生及时给予大剂量甲泼尼龙注射液治疗。临床药师对患者治疗全程实施药学监护,根据患者病情逐渐减少甲泼尼龙注射液剂量,甲泼尼龙注射液治疗9 d后患者病情好转,出院改为口服逐步减少剂量维持6周,一个月后通过电话回访了解到患者病情得到控制。An elderly patient with primary non-small cell lung cancer developed deliriuma, gibberish, and unresponsiveness during treatment with pambolizumab. The clinical pharmacist considers immune-related encephalitis in combination with the patient’s medical history, physical examination, diagnosis and treatment. The adverse drug reaction association evaluation was graded as “very likely”, and clinicians were recommended to give high-dose methylprednisolone injection in a timely manner according to the guidelines. The clinical pharmacist carried out pharmacological monitoring of the patient throughout the treatment process, and gradually reduced the dose of methylprednisolone injection according to the patient’s condition. The patient’s condition improved after 9 days of treatment with methylprednisolone injection, and the discharge was changed to oral gradual reduction dose maintenance therapy for 6 weeks. A follow-up visit to the clinical pharmacist by telephone was informed that the patient’s condition had completely improved. A month later, the clinical pharmacist learned that the patient’s condition was under control by telephone return visit.

关 键 词：帕博利珠单抗 免疫性脑炎 免疫相关的不良事件 药学监护 

分 类 号：R97[医药卫生—药品]