1例结肠癌患者应用西妥昔单抗后出现严重痤疮样皮疹的药学监护

摘要

目的：探讨对结肠癌肝转移患者行西妥昔单抗联合氟尿嘧啶＋亚叶酸钙＋伊立替康＋奥沙利铂（ FOLFIRINOX）方案化疗后出现严重痤疮样皮疹的治疗实施药学监护的切入点。方法：临床药师参与该患者的临床药物治疗全过程，对患者用药后出现痤疮的原因及治疗用药进行分析，开展药学监护。结果：经分析，该患者应用西妥昔单抗联合FOLFIRINOX方案后出现痤疮样皮疹，为西妥昔单抗引起的不良反应。临床药师建议临床医师使用莫匹罗星及头孢克洛对症治疗，减轻了痤疮样皮疹对该患者继续应用西妥昔单抗治疗的影响，确保了患者能够接受足够疗程的治疗，避免了病情延误。结论：临床药师深入临床开展药学监护，可协助临床医师安全、有效用药，避免或减少药品不良反应的发生。%OBJECTIVE:To probe into the entry point of pharmaceutical care for one colorectal liver metastases patient with severe acneiform rash after the treatment of cetuximab combined with chemotherapy FOLFIRINOX. METHODS:Clinical pharmacists participated in the whole course of the patient's therapeutic regimen,and analyzed the cause of acne and application of acne medication then provided pharmaceutical care for the patient.RESULTS:With the analysis of clinical pharmacists, acneiform rash was turned out to be the adverse reactions induced by cetuximab combined with chemotherapy FOLFIRINOX.The clinicians were advised to use mupirocin and cefaclor as expectant treatment,which released the effect of acneiform rash on the patients with continuously application of cetuximab treatment and ensured the patients could receive enough treatment course,avoid delay of the disease.CONCLUSIONS:The clinical pharmacists go into the clinic to develop pharmaceutical care can assist the clinicians with safety and effective medication,and avoid or reduce the incidence of adverse drug reactions.