厄洛替尼致间质性肺炎的药学监护  

Analysis of drug use in erlotinib induced interstitial pneumonia

作　　者：邵佳佳 赵冰清[2] 张艳华[2] 姚晖[1] Shao Jia-jia;Zhao Bing-qing;Zhang Yan-hua;Yao Hui(Department of Clinical Pharmacy,The Second People's Hospital of Foshan,Foshan 528000,China;Key Laboratory of Cancer Pathogenesis and Transformation,Department of Pharmacy,Beijing Institute of Cancer Control and Prevention,Peking University Cancer Hospital,Beijing 100142,China)

机构地区：[1]佛山市第二人民医院临床药学科,佛山528000 [2]北京大学肿瘤医院暨北京市肿瘤防治研究所药剂科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国药物应用与监测》2024年第4期481-483,共3页Chinese Journal of Drug Application and Monitoring

基　　金：佛山市卫生健康局医学科研课题(20240394)。

摘　　要：晚期肺腺癌患者使用盐酸厄洛替尼片后引起间质性肺炎(ILD)的个体化药学监护案例。1例83岁老年女性患者,因“发现右肺肺癌9 d”入院,诊断为右肺腺癌cT2N2M1cⅣB期。入院后行基因检测提示表皮生长因子受体(EGFR)19外显子缺失突变,予盐酸厄洛替尼片(150 mg,每日1次)靶向治疗后10 d出现ILD。临床药师通过对不良反应进行评估,建议给予泼尼松龙1.0~2.0 mg·kg^(-1)·d^(-1)对症处理,同时对患者加强用药教育。治疗后患者的ILD症状改善,换用甲磺酸奥希替尼片(80 mg,每日1次)治疗后再次出现ILD。停用甲磺酸奥希替尼片并再次给予糖皮质激素治疗后患者症状好转出院。An 83-year-old female patient was admitted due to diagnosis of advanced lung adenocarcinoma for 9 days and diagnosed with right lung adenocarcinoma(cT2N2M1cⅣB).After admission,results of the gene test showed a common EGFR mutation(exon 19 deletion)and erlotinib hydrochloride tablets(150 mg,qd)were given to her.Ten days later,she developed interstitial pneumonia(IP).Clinical pharmacists recommended giving prednisolone(1.0-2.0 mg·kg^(-1)·d^(-1))based on the patient’s condition and literature review.She took osimertinib tablets(80 mg,qd)after recovery.And she developed IP again,which was improved after giving prednisolone again and withdrawl of osimertinib.The patient was discharged in good condition.Clinical pharmacists can provide valuable references for clinical rational drug use by deeply analyzing the medication problems.

关 键 词：厄洛替尼 奥希替尼 肺腺癌 间质性肺炎 

分 类 号：R979.1[医药卫生—药品]