1例低剂量表柔比星致重度急性左心衰患者的药学监护

Pharmaceutical Care of One Patient with Severe Acute Left Heart Failure Induced by Low-dose Epirubicin

目的通过参与1例低剂量表柔比星致重度急性左心衰患者的治疗过程,探讨临床药师对化疗患者进行不良反应监护的重要性。方法临床药师从化疗药物方案调整、不良反应相关性和发生不良反应的危险因素等多方面进行分析,对累积剂量仅为51 mg/m^(2)的表柔比星所致严重心衰患者的诊疗过程进行全面的药学监护。结果临床药师协助医师及时判断和处理不良反应,分析潜在危险因素,保证了后续化疗的顺利进行。结论蒽环类药物没有绝对的"安全剂量",临床药师能够协助医师全程监护化疗患者,避免严重不良反应的发生。

Objective To study the importance of clinical pharmacists monitoring adverse reactions among patients under chemotherapy by reviewing the process of treating one patient with severe acute left heart failure induced by low-dose epirubicin.Methods Clinical pharmacists participated in the adjustment of chemotherapy drugs,made correlation analysis,analyzed the risk factors for adverse reactions,and conducted comprehensive pharmaceutical monitoring for a patient with severe heart failure caused by epirubicin at a cumulative dose of only 51 mg/m^(2).Results Clinical pharmacists assisted physicians in making quick judgment and dealing with adverse reactions,analyzed potential risk factors,and removed obstacles to subsequent chemotherapy.Conclusion Anthracyclines have no absolute“safe dose”.Clinicians have to be alert to serious adverse reactions in elderly patients with liver dysfunction,hypoproteinemia,hypercalcemia,and low body weight.Clinical pharmacists can help physicians monitor patients under chemotherapy to prevent serious adverse reactions.