大剂量甲氨蝶呤排泄延迟个体化治疗一例
A case of individualized therapy with delayed excretion of high-dose
赖冉 1杨珺2
作者信息
- 1. 国家癌症中心 国家肿瘤临床医学中心 中国医学科学院北京协和医学院肿瘤医院 药剂科,北京 100021;徐州医科大学附属医院 药学部,江苏 徐州 221002
- 2. 国家癌症中心 国家肿瘤临床医学中心 中国医学科学院北京协和医学院肿瘤医院 药剂科,北京 100021
- 折叠
摘要
本文报道1例中枢弥漫大B细胞淋巴瘤老年患者确诊后给予大剂量甲氨蝶呤方案化疗,化疗24 h后甲氨蝶呤血药浓度达到47.25 μmol/L,提示甲氨蝶呤早期排泄延迟,同时肌酐、尿酸进行性上升.临床药师在大剂量甲氨蝶呤滴注速度的选择、抢救时机和亚叶酸钙抢救方案、分析甲氨蝶呤血药浓度影响因素、药物相互作用、水化、碱化等预处理方案制订,以及药学监护等发挥了积极作用,经医护人员和临床药师的共同努力,患者病情平稳后出院.
Abstract
This paper reports an elderly patient with central diffuse large B lymphoma who was given a high-dose methotrexate regimen after diagnosis.The concentration of methotrexate in the patient reached 47.25 μmol/L 24 h after chemotherapy,suggesting that the early excretion of methotrexate was delayed,while creatinine and uric acid were progressively increased.Clinical pharmacists played an active role in the selection of high-dose methotrexate infusion speed,rescue time,formulation of calcium folinate rescue plan,analysis of factors affecting methotrexate blood concentration,drug interaction,formulation of hydration,alkalization and other pretreatment plans,and pharmaceutical care,etc.The patient was finally discharged after a stable condition through the joint efforts of medical staff and clinical pharmacists.
关键词
大剂量甲氨蝶呤/中枢弥漫大B细胞淋巴瘤/排泄延迟/个体化治疗Key words
high-dose methotrexate/central diffuse large B lymphoma/delayed excretion/individualized therapy引用本文复制引用
出版年
2024
NETL
NSTL
万方数据