1例甲氨蝶呤致严重口腔溃疡和Ⅳ度骨髓抑制合理用药分析

Case Analysis of 1 Patient with Severe Oral Ulcer and Ⅳ Degree Bone Marrow Inhibition Caused by Methotrexate Chemotherapy

目的使临床更加合理地使用甲氨蝶呤(MTX),以减少不良反应的发生。方法临床药师通过参与1例甲氨蝶呤化疗后导致重度口腔溃疡和Ⅳ度骨髓抑制肿瘤患者的会诊和治疗,分别从其原因、防治方法和药学监护等方面进行综合分析。结果提前做好防治措施,可减轻甲氨蝶呤不良反应的程度,增加患者依从性,减少住院天数。结论临床药师参与临床查房、药学监护及会诊,对提高临床诊疗水平及保障患者用药安全、有效、经济、合理具有极大的促进作用。

Objective To make more reasonable clinical use of methotrexate （MTX）and reduce adverse reactions. Methods Pharmacists participated in the diagnosis and treatment of 1 patient with severe oral ulcer and Ⅳ degree bone marrow inhibition caused by the methotrexate chemotherapy . The patients were analyzed comprehensively from their causes ,control methods and pharmacy care . Results Prevention and control measures in advance could reduce the degree of methotrexate adverse reaction,increase patient′s compliance, and reduce the number of days in hospital. Conclusion Clinical pharmacists could promote the level of clinical treatment and contribute to safety,effectiveness,economy,rationality of drug use by participating in the clinical round,pharmaceutical guardianship and consultation.