临床药师参与贝伐珠单抗致血压升高的药学监护

Pharmaceutical care of a patient who developed high blood pressure after bevacizumab treatment

目的:加强药学监护,降低抗肿瘤药不良反应的发生率。方法:针对1例结肠癌复发转移患者,观察其入院治疗用药监护情况。结果:患者入院后行卡培他滨、奥沙利铂(XELOX)及贝伐珠单抗化学治疗后,出现高血压(2级)。临床药师在治疗过程中密切观察病情变化,及时发现不良反应并结合患者既往反流性食管炎病史,建议医生将硝苯地平换用缬沙坦,对患者使用贝伐珠单抗致高血压预防措施进行宣教,最终症状缓解出院。结论:药学监护可以降低抗肿瘤药不良反应的发生率,明显提高患者治疗的安全性。

Objective To reduce the incidence of adverse drug reactions induced by antineoplastic drugs by pharmaceutical care.Methods A patient with colon cancer recurrence and metastasis was chosen,and the medication during hospitalization was observed.Results Hypertension of grade Ⅱ appeared after combined treatment with capecitabine,oxaliplatin （XELOX） and bevacizumab.The clinical pharmacists observed the changes of the patient′s condition and detected the adverse reaction timely.Considering the fact that the patient had reflux esophagitis,the pharmacists suggested the physicians to use valsartan instead of nifedipine to manage the blood pressure.Medication education was given to the patient on prevention of hypertension due to beacizumab.At last,the symptom was relieved,and the patient was discharged . Conclusion Pharmaceutical care can reduce the incidence of adverse drug reactions induced by antineoplastic drugs and improve the medication safety obviously.