临床药师参与1例前列腺癌患者应用奥拉帕利致间质性肺炎伴发热的治疗实践

Clinical Pharmacists'Participation in the Treatment of Olaparib-Induced Interstitial Pneumonia with Fever in a Patient with Prostate Cancer

目的:为发生奥拉帕利致间质性肺炎伴发热的前列腺癌患者用药监护提供参考。方法:对1例口服奥拉帕利片后出现间质性肺炎患者的诊疗过程进行分析,临床药师结合临床药学专业知识,从患者出现发热的原因、间质性肺炎的治疗措施等方面进行分析,提出抗肿瘤治疗调整方案,并实施全程药学监护。结果:患者出现间质性肺炎后应及时停药,并根据不良反应严重程度调整后续治疗剂量,临床药师参与诊疗过程后患者间质性肺炎症状改善明显。结论:奥拉帕利引起的间质性肺炎较少见,临床应注意用药监护、及时调整用药方案并进行对症治疗,同时还需注意药物相互作用对奥拉帕利血药浓度的影响。

Objective:To provide reference for pharmaceutical care in prostate cancer patients with olaparib-induced interstitial pneumonia and fever.Methods:The clinical pharmacists analyzed the diagnosis and treatment process of interstitial pneumonia experienced by a patient after oral administration of olaparib tablets based on the expertise on the clinical pharmacy in terms of the cause of fever and the treatment interventions of interstitial pneumonia,put forward the adjustments to the anti-tumor treatment regimen,and carried out the whole-process pharmaceutical care.Results:The dose discontinuation should be performed for the patient once upon the interstitial pneumonia,and the dose for the subsequent treatment should be adjusted according to the severity of adverse reactions.The symptoms of interstitial pneumonia of the patient were significantly improved during the participation of the clinical pharmacists in the diagnosis and treatment process.Conclusion:Although olaparib-induced interstitial pneumonia is rare,clinical pharmaceutical care should be highlighted to timely adjust medication regimen and provide symptomatic treatment,and meanwhile,the effect of drug interactions on the plasma concentration of olaparib should be paid attention to.