临床药师在厄罗替尼致间质性肺炎患者药物治疗中的作用

发布时间：2017-12-27 08:00

本文关键词：临床药师在厄罗替尼致间质性肺炎患者药物治疗中的作用　出处：《中国药房》2016年17期 　论文类型：期刊论文

【摘要】：目的:探讨临床药师在厄罗替尼致间质性肺炎(ILD)患者药物治疗中的作用。方法:临床药师参与1例肺癌患者胸、腰椎放疗后续厄罗替尼靶向治疗中出现ILD的药物治疗,分析ILD的发生原因,并根据患者实验室检查指标和症状先后建议停用亚胺培南西司他丁钠、氟康唑、厄罗替尼;停用甲基强的松龙,改予泼尼松30 mg,po,qd抗炎;调整泼尼松剂量至40 mg/d,加用羧甲司坦口服液10 ml,tid改善呼吸道症状;将哌拉西林钠舒巴坦钠改为帕尼培南倍他米隆1 g,ivgtt,bid。结果:医师采纳临床药师建议,患者气促、双肺炎症好转,出院带药方案为厄罗替尼150 mg,po,qd。结论:有既往放疗史的患者使用厄罗替尼易发生ILD,临床应用需谨慎。临床药师参与药物治疗,促进了临床安全、合理的用药。
[Abstract]:Objective: To investigate the clinical pharmacists in the erlotinib induced interstitial pneumonia (ILD) patients in the drug treatment effect. Methods: the clinical pharmacists involved in 1 cases of lung cancer of thoracic and lumbar radiotherapy following erlotinib targeting therapy in treatment of ILD, causes ILD, and according to the patients with laboratory indexes and symptoms has recommended to disable Ya Anpei cilastatin sodium, fluconazole, erlotinib; discontinuation of methylprednisolone, modified received prednisone 30 mg, Po, QD and anti-inflammatory prednisone dose; adjusted to 40 mg/d, with 10 ml TID carbocisteine oral liquid, improve the symptoms of respiratory tract; will be changed to piperacillin sodium and sulbactam sodium panipenem betamipron 1 g, IVGTT, bid. Results: the physician adoption of clinical pharmacists suggested that patients with shortness of breath, lung inflammation, discharge medication scheme for erlotinib 150 mg, Po, qd. Conclusion: previous radiotherapy in patients with a history of erlotinib to ILD, clinical application should be cautious. The clinical pharmacist participates in the drug treatment, and promotes the clinical safety and rational use of drugs.
【作者单位】：南昌大学第二附属医院药剂科;南方医科大学南方医院药剂科;
【分类号】：R734.2;R563.13
【正文快照】： 间质性肺炎(Interstitial lung disease,ILD)是以弥散性肺实质、肺泡炎和间质纤维化为病理基本病变,以活动性呼吸困难、X射线胸片示弥散浸润阴影、限制性通气障碍、弥散功能降低和低氧血症为临床表现的不同疾病群构成的临床病理实体的总称。ILD病因复杂,包括吸入无机粉尘、吸

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