临床药师对1例淋巴瘤患儿的药学监护

Pharmaceutical Care for a Child with Lymphoma by Clinical Pharmacist

目的:探讨临床药师对淋巴瘤患儿的药学监护点,促进临床合理用药。方法:临床药师通过参与1例10岁T细胞性淋巴母细胞淋巴瘤患儿的化疗过程,首先针对患儿多程化疗后病情复发,且因蒽环类药物累计剂量造成心功能损伤的情况,协助医师制订化疗方案为改良的BFM-90方案;然后对化疗中出现的左旋门冬酰胺酶致凝血功能障碍、泼尼松致胃肠道反应、5-HT3受体拮抗药致中枢神经系统不良反应及对患儿的用药教育等方面提供药学监护。结果:患儿因化疗引起的凝血功能障碍、胃肠道反应及中枢神经系统反应等不良反应明显减轻,化疗顺利实施。结论:临床药师利用自身的专业知识,参与特殊人群中儿童的肿瘤化疗经过,监测抗肿瘤药物不良反应并制订合理的监护方案,体现了临床药师在肿瘤儿童患者药物治疗中的积极作用。

OBJECTIVE： To discuss the pharmaceutical care for a child with lymphoma in order to improve the rational use of drugs in the clinic. METHODS： By involving chemotherapy course of a 10-year-old child diagnosed as T lymphoblastic lym phoma, clinical pharmacist assisted doctors to formulate modified BFM-90 chemotherapy scheme for the patient whose condi tion relapsed after several chemotherapy courses and the heart function was impaired by accumulated doses of anthracyclines drug. Then clinical pharmacist provided pharmaceutical care on ADR, such as L-asparaginase induced coagulation disorder, gas trointestinal reaction of prednisone and central nervous system ADR caused by 5-HT3 antagonist, and provided medication educa tion for the child. RESULTS： The impaired coagulation function was improved, while the gastrointestinal adverse reaction and the central nervous system adverse reaction caused by chemotherapy were significantly relieved. The chemotherapy was success- fully carried out. CONCLUSIONS： Clinical pharmacists use their professional knowledge to participate in the chemotherapy courses of child to monitor ADR and provide rational pharmaceutical care, which reflect their own value in the chemotherapeu-tic dru treatment.