1例奥拉帕利致Ⅳ度骨髓抑制患者的药学监护  

Pharmaceutical care of a patient with grade Ⅳ myelosuppression induced by olapalil

作　　者：王祺茹 左丽[2] 杜琼[1,3,4] 叶玲 阮聪 翟青 徐蕊[1] WANG Qiru;ZUO Li;DU Qiong;YE Ling;RUAN Cong;ZHAI Qing;XU Rui(Department of Pharmacy,Minhang Branch,Fudan University Cancer Hospital/Shanghai Minhang District Cancer Hospital,Shanghai 200240,China;Department of Oncology,Minhang Branch,Fudan University Cancer Hospital/Shanghai Minhang District Cancer Hospital,Shanghai 200240,China;Department of Pharmacy,Cancer Hospital Affiliated to Fudan University,Shanghai 200032,China;Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属肿瘤医院闵行院区,上海市闵行区肿瘤医院药剂科,上海200240 [2]复旦大学附属肿瘤医院闵行院区,上海市闵行区肿瘤医院肿瘤内科,上海200240 [3]复旦大学附属肿瘤医院药剂科,上海200032 [4]复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中国药物警戒》2023年第10期1176-1180,共5页Chinese Journal of Pharmacovigilance

基　　金：上海市闵行区卫生健康委员会科研课题(2020MW47);上海市闵行区卫生健康委员会科研课题(2022MW40);上海市闵行区卫生健康系统优秀青年药学人才计划(mwyjyx03)。

摘　　要：目的 探讨临床药师参与奥拉帕利致Ⅳ度骨髓抑制的药学干预,为临床安全合理用药提供参考。方法 临床药师参与1例奥拉帕利引起的Ⅳ度骨髓抑制的药学监护及不良反应管理,通过查阅国内外文献并结合多聚腺苷二磷酸核糖聚合酶抑制剂(PARPi)的不良反应管理指南共识,对患者的不良反应症状、生化指标、凝血功能等进行定期监测评估并及时对症治疗,提出个体化用药建议。结果 临床药师与医师紧密协作给予卵巢癌患者服用奥拉帕利后的不良反应管理和药学监护,协助医师优化重启治疗方案,药师随访管理患者8月余,血生化在参考值范围,肿瘤病情稳定,未再出现明显Ⅱ度及以上骨髓抑制。结论 临床药师深入临床参与卵巢癌患者应用奥拉帕利维持治疗的用药监护和不良反应管理,协助医师调整个体化用药方案,可以促进患者用药合理、安全、有效。Objective To investigate the pharmaceutical interventions in one case olapari-induced grade Ⅳ myelopathic depression by clinical pharmacists,and to provide reference for clinical safe and rational drug use.Methods Clinical pharmacists participated in the pharmaceutical care and adverse reaction management of one case of olapari-induced grade Ⅳ myeliopathic depression,regularly monitored and assessed adverse reaction symptoms,biochemical indexes and coagulation function of the patient,initiated immediate symptomatic treatment,and recommended individualized medication by referring to domestic and foreign literature and the consensus on guidelines for management of adverse reactions caused by PARP inhibitors.Results Clinical pharmacists worked in close collaboration with physicians to administer olaparil to this ovarian cancer patient to manage her adverse reactions,and assisted physicians in optimizing and restarting the treatment plan.Pharmacists followed up this patient for more than 8 months,during which time her blood biochemistry was within the reference range,tumor condition was stable,and no obvious grade Ⅱ or above myelopathic suppression occurred again.Conclusion The involvement of clinical pharmacists in drug monitoring and adverse reaction management during olaparil maintenance therapy of ovarian cancer patients,and in adjusting individualized medication plans can promote rational,safe and effective drug use for patients.

关 键 词：奥拉帕利 卵巢癌 骨髓抑制 药品不良反应 药学监护 

分 类 号：R971.6[医药卫生—药品] R994[医药卫生—药学]