肿瘤治疗超说明书用药案例分析

Analysis of Out-label Prescriptions in Cancer Therapy

对我院2014年7-12月门诊中超说明书用药处方184张进行统计, 涉及超给药频次、超剂量、超适应症给药这三类主要情况.其中超适应症给药的有注射用重组人粒细胞巨噬细胞刺激因子治疗放疗后溃疡;醋酸甲羟孕酮片激发癌症晚期患者食欲;奥氮平治疗化疗中呕吐.超剂量给药有白介素-2治疗恶性黑色素瘤;重组人促红素注射液治疗肿瘤化疗后红细胞低下;盐酸氨溴索注射液减少肺癌术后并发症.超给药频次的有硫酸吗啡缓释片治疗癌痛;钙尔奇增频治疗甲状腺癌术后钙、维生素缺少症.超说明书用药均有一定科学理论和临床循证医学的支持,但考虑其药品不良反应和使用风险,仍需更多的临床研究.

A retrospective survey was conducted on 184 out-label prescriptions from our hospital during July-Dec 2014. There were 3 kinds of unlabeled uses, including over-prescription of dosage, frequency or adaptation, respectively. Medicine for over adaptations included recombinant human granulocyte macrophage for post-radiation ulcer, medroxyprogesterone acetate tablets to stimulate appetite of advanced cancer patients and olanzapine for vomit during radiation. Medicine for overdose included interleukin-2 to cure malignant melanoma, recombinant human erythropoietin injections to cure low erythrocyte after tumor radiation,and ambroxol hydrochloride injections to cure postsurgery complications of lung cancer. Medicine for over frequency included morphine sulfate sustained-release tablets to cure cancer pain, caltrate to cure post-surgery of thyroid cancer. Unlabeled use of medicines in our hospital is depended on some scientific theory and clinical experiments. But considering adverse reaction and risk, it needs more clinical researches before wide use.