1例肺癌并发肾功能不全患者接受培美曲塞化学治疗的药学监护

Pharmaceutical Care for a Patient with Lung Cancer Complicated with Renal Insufficiency Receiving Pemetrexed Chemotherapy

目的探讨肺癌并发肾功能不全患者接受培美曲塞化学治疗(化疗)的药学监护。方法 1例肺癌并发肾功能不全患者接受培美曲塞化疗的过程中存在安全性风险,临床药师以此为切入点,为该患者提供个体化药学监护服务。结果临床药师与临床医师充分评估此病例接受培美曲塞化疗的风险,协助医生完善治疗方案,对患者进行用药教育。患者未见严重的毒副反应,并获得了良好的抗肿瘤效果。结论对于肺癌并发肾功能不全接受培美曲塞化疗的患者,临床药师需要重点关注肌酐清除率,是否联合使用铂类抗肿瘤药、非甾体类抗炎药和唑来膦酸,以及随访患者的不良反应和抗肿瘤疗效。

Objective To explore the pharmaceutical care approaches for patients with lung cancer complicated with renal insufficiency receiving pemetrexed chemotherapy. Methods An elderly patient with lung cancer complicated with renal insufficiency receiving pemetrexed chemotherapy faced inevitable safety risks.Clinical pharmacists considered it as an intervention point, and provided individual pharmaceutical care. Results Clinical pharmacists fully assessed the safety risks of the case receiving pemetrexed chemotherapy with clinicians, assisted in improving the therapeutic regimen, and carried out medication education for the patient. No serious adverse drug reactions occurred in the patient, and anti-tumor efficacy was obtained. Conclusion For patients of lung cancer complicated with renal insufficiency receiving pemetrexed chemotherapy, clinical pharmacists should focus on creatinine clearance rate, and decide whether the combined use of platinum anti-tumor drugs, non steroidal anti-inflammatory drugs and zoledronic acid can be adopted, and follow-up on adverse drug reactions and anti-tumor efficacy.