1例卵巢癌伴淋巴结核规律血透患者复杂药物治疗的药学干预

发布时间：2018-07-04 18:10

本文选题：临床药师 + 抗结核治疗　；参考：《中国药学杂志》2015年07期

【摘要】：目的临床药师通过对1例国内外罕见报道的卵巢癌术后复发伴淋巴结核血透患者的抗结核和化疗方案进行药学干预,达到了较好的治疗效果。方法临床药师在血液透析患者化疗与抗结核治疗的复杂情况下,利用自己药学专业知识,查阅国内外相关资料,确定患者的抗结核及化疗方案,优化卡铂剂量,并对患者进行游离铂的浓度测定及不良反应等药学监护,计算AUC,优化下一次给药方案。结果全院会诊建议患者先进行抗结核治疗,待淋巴结结核有所控制后再进行卵巢癌化疗。临床药师在医师会诊讨论基础上优化治疗方案为:利福平0.45g,1日1次,晨空腹服;异烟肼,0.3g,1日1次,透析当日在透析后给药;乙胺丁醇0.75g,每周一、三、五透析后给药;根据Calvert公式计算卡铂0.15g,并予以紫杉醇0.15g·m-2化疗。给药结束24h后进行血液透析,血液透析维持3h,游离铂的浓度测定,化疗第2~4疗程方案为紫杉醇0.15g·m-2,卡铂0.166g,给药方式同第一疗程。在整个化疗过程中,患者无明显不良反应,抗结核治疗和化疗均取得较好疗效,且患者耐受性良好。结论临床药师根据药物的药动学和药效学特点,结合患者病理生理情况,为患者设计最佳治疗方案、预防不良反应、监测治疗效果,使患者获得最佳治疗。
[Abstract]:Objective the clinical pharmacist of 1 cases of recurrent ovarian cancer with recurrent tuberculous hemodialysis and chemotherapy for tuberculosis and chemotherapy has achieved good therapeutic effect. Methods clinical pharmacists use their own professional knowledge of pharmacy under the complicated situation of chemotherapy and anti tuberculosis treatment in hemodialysis patients. At home and abroad, the patient's anti tuberculosis and chemotherapy regimen were determined, the dose of carboplatin was optimized, the concentration of free platinum was measured and the adverse drug monitoring, AUC was calculated to optimize the next drug delivery scheme. Chemotherapy. The clinical pharmacist optimized the treatment plan on the basis of physician consultation discussion: rifampin 0.45g, 1 times on 1 days, morning clothes, isoniazid, 0.3g, 1 days 1 times, dialysate on the day of dialysis; ethambutol 0.75g, every Monday, three, five dialysis; calculate carboplatin 0.15g according to the Calvert formula, and give paclitaxel 0.15g m-2 chemotherapy. The administration ended 2. After 4h, hemodialysis, hemodialysis maintenance of 3H, concentration of free platinum, 2~4 course of chemotherapy for paclitaxel 0.15g. M-2, carboplatin 0.166g, the same course of administration as the first course. In the whole course of chemotherapy, the patients have no obvious adverse reaction, the anti tuberculosis treatment and chemotherapy are all good curative effect, and the patient is well tolerated. Conclusion clinical medicine. According to the pharmacokinetic and pharmacodynamic characteristics of the drug, combined with the pathophysiology of the patient, the teacher designed the best treatment plan for the patients, prevented the adverse reaction, monitored the effect of the treatment, and made the patients get the best treatment.
【作者单位】：中山大学附属第一医院药学部;中山大学药学院;
【分类号】：R737.31

【参考文献】