帕博利珠单抗致患者肌炎伴重症肌无力的用药分析  

Pharmaceutical care of clinical pharmacists participating in immune checkpoint inhibitor induced myositis with myasthenia gravis

作　　者：孙雯娟[1] 胡扬[1] 徐燕 张波[1] SUN Wen-juan;HU Yang;XU Yan;ZHANG Bo(Department of Pharmacy,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing 100730,China;Department of Respiratory Diseases,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医院药剂科,北京100730 [2]中国医学科学院,北京协和医院呼吸与危重症医学科,北京100730

出　　处：《中国临床药理学杂志》2023年第7期1037-1039,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：帕博利珠单抗引起的肌炎伴重症肌无力的药物不良反应罕见,但致死率较高。临床治疗方案存在多药并用的情况,免疫相关的药物不良反应(irAE)判断与鉴别难度高,救治难度高。本文介绍临床药师参与1例帕博利珠单抗致肌炎伴重症肌无力的药学会诊,参与药物不良反应判断、处置,协助医师制定治疗方案并根据患者情况适时调整。最终,患者发生的肌炎、重症肌无力等药物不良反应均得到了有效控制与改善。对于应用免疫检查点抑制药的肿瘤患者,临床药师应着力于irAE的鉴别、合并症的处理、最佳有效处理措施与时机的药学监护,保障肿瘤患者用药安全。Myositis with myasthenia gravis caused by pembrolizumab was rare but fatal.Multiple drugs are used in clinical treatment regimens,and it is difficult to judge and identify immune related adverse effect(irAE),and difficult to treat.Clinical pharmacists analyzed the adverse relevance judgment,disposal,and assisted physicians in making and adjusting treatment plan according to patients,conditions.Finally,adverse drug reactions of patients were controlled and improvemented.The implementation of pharmaceutical care effectively ensure the safety and rational drug use of patients.

关 键 词：免疫检查点抑制药 重症肌无力 临床药师 药物不良反应 

分 类 号：R979[医药卫生—药品]