老年肺癌化疗患者肾功能损伤加重的用药分析

doi:10.19803/j.1672-8629.2020.08.09

中国药物警戒 ›› 2020, Vol. 17 ›› Issue (8): 491-495.
DOI: 10.19803/j.1672-8629.2020.08.09

老年肺癌化疗患者肾功能损伤加重的用药分析

张秀敏¹, 蔡晶²

¹汕头市中心医院药学部,广东汕头 515031;
²南方医科大学南方医院药学部,广东广州 510515

收稿日期:2020-07-31 修回日期:2020-07-31 出版日期:2020-08-15 发布日期:2020-07-31
通讯作者: ^*蔡晶,女,博士,副主任药师,临床药学。E-mail：37136875@qq.com
作者简介:张秀敏,女,主管药师,本科,临床药学。

Pharmaceutical Care of Aggravating Renal Function Injury in an Elderly Patient with Lung Cancer Undergoing Chemotherapy

ZHANG Xiumin¹, CAI Jing²

¹Department of Pharmacy, the Central Hospital of Shantou, Shantou Guangdong 515031, China;
²Department of Pharmacy, Nanfang Hospital, Guangzhou Guangdong 510515, China

Received:2020-07-31 Revised:2020-07-31 Online:2020-08-15 Published:2020-07-31
Supported by:
广东省科技计划项目（2016A04043051）：药物临床评价体系关键技术研究及应用示范

摘要/Abstract

摘要： 目的分析患者化疗后肾功能损伤加重的药品相关原因,为临床化疗方案的调整和监护提供参考。方法对1例老年肺癌化疗患者的病例资料进行回顾性分析,结合临床药学专业知识,分析其用药方案中可能造成肾功能损伤加重的药品原因,查阅相关文献,为患者用药方案调整和监护提出建议。结果该患者肾功能损伤加重和顺铂、培美曲塞、造影剂的相关性判定均为“可能”,和贝伐珠单抗的相关性判定为“可疑”。对于肾功能损伤患者,使用顺铂和造影剂时需注意充分水化,且需间隔72 h以上。CrCl<30 mL/min时,停用顺铂和培美曲塞。结论临床药师全程参与制定药物治疗方案并开展药学监护,掌握相关药品不良反应,对于同时使用多种有肾毒性药物的患者,做好预处理和用药监测,需综合评估其疗效与不良反应,从而在临床治疗团队发挥积极作用。

关键词: 顺铂, 培美曲塞, 造影剂, 贝伐珠单抗, 肾功能损伤

Abstract: Objective To analyze drug-caused aggravation of renal function injury during chemotherapy in order to provide reference for the adjustment and monitoring of clinical chemotherapy. Methods The clinical data of an elderly chemotherapy patient with lung cancer was analyzed retrospectively. All the drugs that might have been associated with his aggravating renal damage were analyzed. Results The correlations between his ongoing renal damage and cisplatin, pemetrexed, radiocontrast agents were considered "possible". At the same time, bevacizumab seemed "suspicious". For patients with renal damage, adequate hydration should be combined with cisplatin or a radiocontrast agent. An interval of more than 72 hours is recommended. Cisplatin or pemetrexed should not be used when CrCl is less than 30 mL/min. Conclusion Multiple drugs with renal toxicity may be used at the same time during clinical practice, so it is important to have an intimate knowledge of properties of drugs while working hard to reduce adverse reactions and improve curative effect.

Key words: cisplatin, pemetrexed, contrast agent, bevacizumab, renal damage

中图分类号:

R916.696

张秀敏, 蔡晶. 老年肺癌化疗患者肾功能损伤加重的用药分析[J]. 中国药物警戒, 2020, 17(8): 491-495.

ZHANG Xiumin, CAI Jing. Pharmaceutical Care of Aggravating Renal Function Injury in an Elderly Patient with Lung Cancer Undergoing Chemotherapy[J]. Chinese Journal of Pharmacovigilance, 2020, 17(8): 491-495.

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老年肺癌化疗患者肾功能损伤加重的用药分析

Pharmaceutical Care of Aggravating Renal Function Injury in an Elderly Patient with Lung Cancer Undergoing Chemotherapy

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