疑似奥沙利铂致免疫性血小板减少症的药学实践与分析

Pharmaceutical practice and analysis for the suspected oxaliplatin-induced immune thrombocytopenia

目的探讨不同机制下奥沙利铂致血小板降低的特征以及临床药师参加药物治疗实践的模式,为奥沙利铂相关血小板减少症的防治提供参考。方法临床药师对疑似奥沙利铂致免疫性血小板减少症患者开展药学监护,将其与骨髓抑制性血小板减少症对比分析,探讨不同机制下奥沙利铂致血小板减少症的特征,协助医师制订不良反应处理方案。结果药师协助医师鉴别奥沙利铂致血小板降低的机制,做出正确干预。患者血小板恢复至正常值,安全度过化疗期。结论早期鉴别奥沙利铂引起血小板下降的机制可帮助医师及时诊断。临床药师可以通过药物不良反应的防治参与临床实践工作,保障患者安全用药。

Objective To explore the characteristics of oxaliplatin-induced thrombocytopenia under different mechanisms and the mode of clinical pharmacists participating in drug therapy,providing reference for its prevention and treatment.Methods Clinical pharmacist conducted pharmaceutical care for a patient suspected oxaliplatin-induced immune thrombocytopenia,which was compared with myelosuppressive thrombocytopenia,to explore the characteristics of the oxaliplatin-induced thrombocytopenia under different mechanisms.Meanwhile,clinical pharmacists assisted physicians in solving out the adverse effects.Results Pharmacists assisted the clinicians in identifying the mechanisms of oxaliplatin-induced thrombocytopenia and made the correct intervention.The platelet level of the patient returned to the normal range who lived safely through chemotherapy.Conclusion Early identification of the mechanism of oxaliplatin-induced thrombocytopenia helps clinicians make correct diagnosis in time.Clinical pharmacists can participate in the clinical practice of prevention and treatment of adverse drug reaction and escort the safety of drug use.