Pharmacological Monitoring of Capecitabine in a Gastric Cancer Patient with Hyperbilirubinemia  

作　　者：Yanting Gu Qinghua Lang Dongmei Chen Jianying Zhang Zheng Liu Ling Gao Yanting Gu;Qinghua Lang;Dongmei Chen;Jianying Zhang;Zheng Liu;Ling Gao(Department of Pharmacy, China Aerospace Science & Industry Corporation 731 Hospital, Beijing, China;Department of Nursing, Liupanshui Municipal People’s Hospital, Liupanshui, China;Department of Nursing, Zhongshan People’s Hospital of Guangdong Province, Zhongshan, China)

机构地区：[1]Department of Pharmacy, China Aerospace Science & Industry Corporation 731 Hospital, Beijing, China [2]Department of Nursing, Liupanshui Municipal People’s Hospital, Liupanshui, China [3]Department of Nursing, Zhongshan People’s Hospital of Guangdong Province, Zhongshan, China

出　　处：《Journal of Biosciences and Medicines》2023年第3期120-126,共7页生物科学与医学（英文）

摘　　要：Objective: To examine therapeutic drug monitoring in managing hyperbilirubinemia caused by capecitabine in patients with gastric adenocarcinoma with extensive liver metastases. Results: The initial liver function tests showed an elevation of transaminases (aspartate amino transferase 615 UI/l, alanine aminotransferase 385.9 UI/l), hyperbilirubinemia (total bilirubin at 246.1 μmol/l), and alkaline phosphatase at 694.6 UI/l. We initiated capecitabine based combination chemotherapy, and the clinical pharmacist conducted a full-course medication monitoring of the patient’s treatment including design of individualized dosing regimens and monitoring of bilirubin, infection, cancer pain, parenteral nutrition support and adverse events. After 21 days of supervision by clinical pharmacist and clinicians, the patient’s bilirubin and transaminase decreased progressively, with aspartate aminotransferase, total bilirubin and alkaline phosphatase falling back to 57 UI/l, 69.8 μmol/l, 307.2 UI/l, respectively. The patient’s condition improved significantly at the time of discharge, with the jaundice subsided, and the bloating relieved. Conclusion: Due to adverse reactions, capecitabine requires medication monitoring during use. The relationship between effectiveness and adverse effects is controversial. Adverse reactions should not be the sole criterion for the use of drugs. Clinical pharmacists can improve the safety and effectiveness of patients’ medications and promote rational drug use by monitoring patients, which may be useful to help the doctors identify the high-risk patients for taking efficient treatment strategy decisions.Objective: To examine therapeutic drug monitoring in managing hyperbilirubinemia caused by capecitabine in patients with gastric adenocarcinoma with extensive liver metastases. Results: The initial liver function tests showed an elevation of transaminases (aspartate amino transferase 615 UI/l, alanine aminotransferase 385.9 UI/l), hyperbilirubinemia (total bilirubin at 246.1 μmol/l), and alkaline phosphatase at 694.6 UI/l. We initiated capecitabine based combination chemotherapy, and the clinical pharmacist conducted a full-course medication monitoring of the patient’s treatment including design of individualized dosing regimens and monitoring of bilirubin, infection, cancer pain, parenteral nutrition support and adverse events. After 21 days of supervision by clinical pharmacist and clinicians, the patient’s bilirubin and transaminase decreased progressively, with aspartate aminotransferase, total bilirubin and alkaline phosphatase falling back to 57 UI/l, 69.8 μmol/l, 307.2 UI/l, respectively. The patient’s condition improved significantly at the time of discharge, with the jaundice subsided, and the bloating relieved. Conclusion: Due to adverse reactions, capecitabine requires medication monitoring during use. The relationship between effectiveness and adverse effects is controversial. Adverse reactions should not be the sole criterion for the use of drugs. Clinical pharmacists can improve the safety and effectiveness of patients’ medications and promote rational drug use by monitoring patients, which may be useful to help the doctors identify the high-risk patients for taking efficient treatment strategy decisions.

关 键 词：Clinical Pharmacist CAPECITABINE Gastric Cancer HYPERBILIRUBINEMIA Therapeutic Drug Monitoring 

分 类 号：R73[医药卫生—肿瘤]