安罗替尼致高血压伴蛋白尿的分析与药学监护

Analysis and Pharmaceutical Care of Hypertension Complicated with Proteinuria Induced by Anlotinib

目的:探讨安罗替尼治疗晚期恶性肿瘤期间发生高血压伴蛋白尿不良反应的临床特点及机制,为临床合理用药提供参考。方法:收集2018年6月至2020年7月山东省广饶县人民医院使用安罗替尼的晚期恶性肿瘤患者,临床药师参与安罗替尼致高血压伴蛋白尿不良反应的监测评估及分析,协助医师对安罗替尼剂量以及抗高血压药物治疗方案进行调整。结果:共纳入123例使用安罗替尼治疗的晚期恶性肿瘤患者,其中6例患者出现了高血压伴蛋白尿的不良反应,该不良反应发生率为4.88%。治疗期间,临床药师提供了药学监护,制定了个体化用药方案,最终患者的血压均控制良好,尿蛋白恢复阴性,保证了抗肿瘤治疗的连续性。结论:临床药师应掌握新型抗肿瘤药的相关理论,积极开展药学监护,参与临床治疗方案的优化,提高药物治疗效果,促进临床合理用药。

OBJECTIVE:To explore the clinical characteristics and mechanism of adverse drug reactions of hypertension complicated with proteinuria during the treatment of advanced malignant tumor with anlotinib,so as to provide reference for safe and rational drug use.METHODS:Patients with advanced malignant tumor treated with anlotinib in People’s Hospital of Shandong Guangrao County from Jun.2018 to Jul.2020 were collected.Clinical pharmacists participated into the monitoring,evaluation and analysis of adverse drug reactions of hypertension complicated with proteinuria induced by anlotinib,assisted clinicians to adjust the dosage of antihypertensive drugs and antihypertensive therapy.RESULTS:A total of 123 patients with advanced malignant tumor treated with anlotinib were included,of which 6 patients developed adverse drug reactions of hypertension complicated with proteinuria,with the incidence of 4.88%.During the treatment period,the clinical pharmacist provided pharmacological monitoring and developed individualized medication regimens.Ultimately,all patients’blood pressure was well controlled and urine protein returned to negative,which ensured the continuity of anti-tumor therapy.CONCLUSIONS:Clinical pharmacists should master the relevant theories of new anti-tumor drugs,actively carry out pharmaceutical care,participate into the optimization of clinical treatment regimens,improve the level of drug therapy,and promote the safety and rationality of clinical drug use.