McCune-Albright综合征患儿超说明书用药并文献复习

Off-label Drug Use in A Child with McCune-Albright Syndrome and Its Literature Review

探讨甲羟孕酮、来曲唑和唑来膦酸超说明书用药的合理性。方法:1例6岁8个月男性患儿,出生时发现左臀部咖啡样色斑,4岁颅面部畸形,5岁时出现第二性征发育,同时出现骨龄超前,诊断为"Mc Cune-Albright综合征"。入院后,相继给予甲羟孕酮片(4 mg bid po)+来曲唑片(1.25 mg qd po)+唑来膦酸注射液(3 mg once iv gtt)+碳酸钙片(250 mg qd po)和维生素AD滴剂(胶囊型)(1粒qd po)治疗。结果:经过23 d的对症治疗后,患者一般情况及症状稳定,要求出院。结论:临床药师参与患者的药物治疗过程,对唑来膦酸和甲羟孕酮、来曲唑的超说明书用药有了进一步的认识,提高了药物的治疗水平。临床药师通过参与临床实践,协助医师参与患者的用药监护,提高药物治疗的安全性。

Objective:To investigate the rationality of off-label drug use of medroxyprogesterone,letrozol and zoledronate.Methods:A male patient aged 6 years and 8 months was found to have coffee-like spots in the left hip at birth,cranial facial deformity at the age of four,secondary sexual development and advanced bone age at the age of 5 and was diagnosed as"McCune-Albright Syndrome".After admission,he was given medroxyprogesterone(4 mg bid po)+letrozole(1.25 mg qd po)+zoledronate(1.25 mg qd po)+calcium carbonate(250 mg qd po)and vitamin AD(capsule)(1pill qd po).Results:After 23 days of treatment,the general situation and symptoms of the patient were stable and the patient required to be discharged.Conclusion:Through participating in drug therapy for the patient,clinical pharmacists acquired further understanding on off-label use of zoledronate and medroxyprogesterone,letrozole to improve the level of medication.Through participating in clinical practice,clinical pharmacists assisted physicians in monitoring medication,which improved the safety of medication.