从药品不良事件谈临床药师对肿瘤患者的用药监护.doc

9从药品不良事件谈临床药师对肿瘤患者的用药监护蔡和平王卓*黄瑾徐慧欣杨黎（第二军医大学长海医院药学部上海200433）【摘要】目的：分析第二军医大学长海医院抗肿瘤药品不良事件(ADE)的发生情况及其规律寻找临床药师对肿瘤患者用药监护的要点提高抗肿瘤药物的合理用药水平。方法：2004年～2009年全院上报的108例抗肿瘤ADE病例报告进行分类频数统计和分析评价提出临床药师用药监护点。结果：发生ADE的病例中男性居多。用药当日发生ADE的比例最高。抗肿瘤药物中ADE发生率排居前三位的分别为：奥沙利铂、甲氨蝶呤与紫杉醇。抗肿瘤药物ADE累及系统器官排居前三位的为：中枢神经系统、消化系统及免疫系统。结论：临床药师应重点关注肿瘤患者用药人群、抗肿瘤药物ADE发生时间及抗肿瘤药物ADE累及的器官及表现。通过加强临床药师对抗肿瘤药物用药过程的观察和监护减少ADE的发生及其造成的损害促进合理用药。【关键词】抗肿瘤药物；药品不良事件；用药监护；合理用药Pharmaceuticalcarepointsontumorpatient——discussionfromadversedrugeventsofantineoplasticmedicineCAIHe-pingWANGZhuo*HUANGJinYANGLi(DepartmentofPharmacyChanghaiHospitalSecondMilitaryMedicalUniversityShanghai200433China)[ABSTRACT]Objective：Toanalyzethecharacteristicsandtheregularityoftheantineoplasticsdruginducedadversedrugevents(ADE)inChanghaihospitalofSecondMilitaryMedicalUniversity;discussthepharmaceuticalcarepointofclinicalpharmacistsoastoprovidereferenceforclinicalsafeandrationalmedication.Methods：Atotalof108casesofADEreportscollectedbyADEmonitoringcenterinthehospitalin2004to2007wereclassifiedandanalyzedstatistically.Thensummarizethepharmaceuticalcarepointsontumorpatientbyclinicalpharmacist.Results：MaleshowedthehigherproportionsofADEthanfemale.ADEoccuredmostoftenonthefirstday.Intheantineoplasticsmedicinesmethopterinoxaliplatinandpaclitaxetookthetop3offrequency.Nervoussystemdigestivesystemandimmunesystemisthetop3involvedsystem-organ.Conclusion:Clinicalpharmacistshouldpayattentiontothepatientgivenantineoplasticdrug.ADEoccurrencetimeantimetaboliteantineoplasticdrugandADEinvolvedorganisthekeypointsbeingtakencareof.MoreattentionshouldbepaidbyclinicalpharmacisttotheantineoplasticdrugusageinordertoavoidorreducetheincidenceofADEandpromoterationalmedication.[KEYWORDS]antineoplastics；adversedrugevents;pharmaceuticalcare;rationaluseofdrugs