1例盐酸厄洛替尼片致严重皮肤溃疡和角膜穿孔的药学监护

Pharmaceutical care for a case of severe skin ulcer and corneal perforation caused by erlotinib hydrochloride tablets

目的对1例肺癌患者口服厄洛替尼发生不良反应的观察与随访,优化临床药师的用药监护和提高血药浓度监测(TDM)对患者的治疗作用。方法结合1例肺癌患者口服盐酸厄洛替尼片(特罗凯)治疗后同时发生皮肤溃疡和角膜穿孔的严重不良反应,临床药师采用循证药学和TDM对其进行药学监护。结果通过个体化用药调整,对发生的不良反应给予对症支持治疗,患者皮肤溃疡与角膜穿孔虽未能治愈,但疼痛明显缓解。结论临床药师在肿瘤患者用药治疗过程中,可利用临床药学专业协助临床医师对患者的个体化治疗提供药学服务,促进临床合理用药。

Objective To optimize medication monitoring by clinical pharmacists and improve the role of therapeutic drug monitoring(TDM) via observation and follow-up of one case of adverse reactions caused by oral erlotinib.Methods Soon after one patient with lung cancer developed skin ulcer and corneal perforation following treatment with oral erlotinib,clinical pharmacists gave pharmaceutical care using evidence-based pharmacy and TDM.Results Through adjustment of the individualized medication regimen,symptomatic and supportive treatment of adverse reactions,the pain of the patient was significantly relieved,although her skin ulcer and corneal perforation were not cured.Conclusion In the course of medication for cancer patients,clinical pharmacists can use their expertise and knowledge to assist clinicians in providing individualized pharmaceutical care for patients,and contribute to rational clinical use of drugs.