临床药师参与1例羟基脲致下肢皮肤溃疡用药实践  

Clinical Pharmacists′Interventions in the Medication Treatment of Lower Extremity Skin Ulcer Induced by Hydroxycarbamide:A Case Report

作　　者：戴文真 单雪峰[1] 郑姣妮[1] DAI Wenzhen;SHAN Xuefeng;ZHENG Jiaoni(Bishan Hospital of Chongqing Medical University·Bishan Hospital of Chongqing,Chongqing,China 402760)

机构地区：[1]重庆医科大学附属璧山医院·重庆市璧山区人民医院,重庆402760

出　　处：《中国药业》2024年第20期126-128,共3页China Pharmaceuticals

基　　金：重庆市卫生健康委员会临床药学重点专科建设项目[渝卫办发〔2023〕69号];重庆市璧山区科学技术局科技计划项目[BSKJ2023032];重庆市璧山区卫生健康委员会临床医学重点专科建设项目[璧卫发〔2023〕158号]。

摘　　要：目的为羟基脲致下肢皮肤溃疡的诊治提供参考。方法回顾医院收治的1例羟基脲治疗原发性血小板增多症(ET)引起下肢溃疡老年女性患者的诊治过程。患者入院后经验性给予注射用阿莫西林钠克拉维酸钾静脉滴注+羟基脲片口服。但临床药师查房追问病史发现,患者近1年反复出现口腔溃疡且不易恢复,根据患者用药史、羟基脲药品说明书和相关文献,考虑为羟基脲引起的皮肤血管毒性,建议主管医师减量或换药。结果综合血液科医师会诊意见,主管医师换药为阿那格雷。20 d后患者症状改善,带药出院。结论临床药师参与临床会诊,可保证患者用药的安全有效;建议将使用羟基脲的患者纳入重点监护人群,尽早发现该类患者可能出现的药品不良反应,尽早干预,以减少其发生风险。Objective To provide a reference for the diagnosis and treatment of lower extremity skin ulcer induced by hydroxycarbamide.Methods The diagnosis and treatment process of an elderly female patient with lower extremity skin ulcer induced by hydroxycarbamide in the treatment of essential throbocythemia(ET)in the hospital was retrospectively analyzed.After admission,the patient was given the intravenous drip of Amoxicillin Sodium and Clavulanate Potassium for Injection+oral Hydroxycarbamide Tablets based on the chief physician′s experience,while the clinical pharmacists found that the patient had recurrent oral ulcer in the past year that was difficult to recover during ward rounds.Based on the patient′s medication history,hydroxycarbamide instructions and relevant literature,the clinical pharmacists considered the oral ulcer was the skin vascular toxicity induced by hydroxycarbamide,and suggested the chief physician decrease dosage or change drug.Results Based on the consultation opinions of clinical pharmacists and hematology physicians,the chief physician replaced hydroxycarbamide with Anagrelid.The patient′s symptoms improved and discharged with medication after 20 d.Conclusion Clinical pharmacists′participation in the clinical consultations can ensure the safety and effectiveness of medication for patients.It is suggested that we should include the patients taking hydroxycarbamide in the key monitoring population,detect the potential adverse drug reactions early in such patients and take effective intervention measures to decrease the risk of adverse reactions.

关 键 词：临床药师 羟基脲 皮肤溃疡 原发性血小板增多症 药学监护 

分 类 号：R969.3[医药卫生—药理学]