注射用紫杉醇(白蛋白结合型)输液器选择错误致过滤器阻塞

Filter blockage caused by wrong selection of paclitaxel for injection(albumin bound)infusion device

1例77岁女性患者因卵巢恶性肿瘤伴腹膜转移给予注射用紫杉醇(白蛋白结合型)联合奈达铂化疗。首次给予注射用紫杉醇(白蛋白结合型)100 mg溶于0.9%氯化钠注射液250 ml静脉滴注时出现输液不畅、滴速缓慢现象。停止输注后检查输液器,发现过滤器上方有白色絮状物沉淀。临床药师排除药物配制和配伍禁忌导致沉淀的可能性,发现本例患者使用的输液器为精密输液器(微孔过滤器的孔径为5μm),而紫杉醇(白蛋白结合型)药品说明书中指出:“不应使用孔径小于15μm的过滤器,否则可能会导致过滤器堵塞。”次日更换普通输液器(孔径20μm),再次静脉滴注注射用紫杉醇(白蛋白结合型),过程顺利,未再发生堵塞现象。

A 77-year-old female patient was given combined chemotherapy with paclitaxel for injection(albumin bound)and nedaplatin for ovarian malignant tumor with peritoneal metastasis.When paclitaxel for injection(albumin bound)100 mg dissolved in 0.9%sodium chloride injection 250 ml was given intravenously for the first time,the infusion was not smooth and the drip rate was slow.After stopping infusion,the infusion device was checked and white flocculent sediment above the filter was found.Clinical pharmacists ruled out the possibility of precipitation caused by drug preparation and incompatibility contraindications,and found that the infusion device used by this patient was a precision one(the pore diameter of microporous filter was 5μm).However,in the drug label of paclitaxel for injection(albumin bound),it was pointed out that"Use of filters with a pore size less than 15μm may result in blockage of the filter and should not be used."On the second day,a general infusion device(filter with 20μm pore size)was used for IV infusion of paclitaxel for injection(albumin bound)and the process was smooth and no blockage recurred.