1例小细胞肺癌患者化疗的药学监护

Pharmaceutical Care for One Patient with Small Cell Lung Cancer Receiving Chemotherapy

目的:探讨临床药师对化疗患者进行药学监护的方法,促进合理用药。方法:针对1例小细胞肺癌化疗患者,临床药师分析化疗方案,提供药学监护。结果:该患者的化疗方案为伊立替康联合顺铂,药品不良反应的发生率较高,临床药师及时地制订和调整化疗方案,合理地应用药物预防方案,避免了更严重不良反应的发生;对化疗过程中出现的骨髓抑制、严重腹泻、肠梗阻等问题,结合患者病情,依据相关治疗指南及临床药学知识,与临床医师共同讨论和实施升高白细胞、止泻及胃肠减压等用药方案,根据疗效及时调整用药,使肿瘤患者顺利完成化疗周期。结论:临床药师应深入临床,参与患者治疗全过程,密切配合医师监测患者各项临床指标,协助制定治疗方案,并对患者进行用药指导,以促进临床安全、有效用药。

OBJECTIVE： To explore the approaches for clinical pharmacist to carry out pharmaceutical care for patient receiving chemotherapy so as to promote rational use of drug. METHODS： Clinical pharmacist analyzed the chemotherapy regimen and provided pharmaceutical care for one patient with small cell lung cancer（ SCLC） . RESULTS：The chemotherapy regimen consisted of irinotecan and cisplatin; due to the high incidence of adverse drug reactions, clinical pharmacist timely formulated and adjusted the chemotherapy, reasonably applied the chemoprophylaxis programs, which helped avoid the occurrence of more serious adverse reactions; clinical pharmacist discussed the problems noted during chemotherapy such as bone marrow suppression, severe diarrhea, intestinal obstruction etc with clinicians based on patients- condition taking the related treatment guideline and clinical pharmaceutical knowledge as references, carried out a series of schemes to increase white blood cell count, check diarrhea and achieve gastrointestinal decompression, adjusted drug use based on efficacy, which facilitated cancer patients- smooth completion of periodical chemotherapy. CONCLUSIONS：Clinical pharmacists‘involvement in patients’ clinical treatment by closely cooperate with physicians to monitor patients-clinical indicators, make therapeutic regimens, provide medication guidance among patients contributed to patients- safe and effective medication.