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临床药师对奥沙利铂致视觉异常患者的药学监护
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| 篇名： | 临床药师对奥沙利铂致视觉异常患者的药学监护 |
| TITLE： | Pharmaceutical care for a patient with visual abnormalities induced by oxaliplatin by clinical pharmacists |
| 摘要： | 目的 报告1例奥沙利铂致视觉异常的病例，为临床安全用药提供参考。方法临床药师对1例使用奥沙利铂期间出现视觉异常的结肠癌患者开展了药学监护。针对首个奥沙利铂化疗周期内患者先后两次发生视觉异常，临床药师建议停用奥沙利铂，并建议减少下个化疗周期奥沙利铂的剂量；针对第2个化疗周期患者仍发生视觉异常，临床药师建议永久停用奥沙利铂；同时，对患者及家属进行用药宣教。临床药师通过Naranjo’s评估量表判断奥沙利铂与视觉异常的相关性，并分析该不良反应的发生特点。结果与结论医师采纳临床药师的建议。停用该药后，患者视力逐渐恢复正常。奥沙利铂与视觉异常的相关性为“很可能”。奥沙利铂致视觉异常较为罕见，常发生在用药的前3个周期；大部分患者的视力可在停药后2周内恢复正常，少数患者会进展为永久性视觉损害。临床药师通过评估奥沙利铂与视觉异常的相关性、调整用药方案、开展药学监护和用药宣教等药学服务手段，保障了患者的用药安全。 |
| ABSTRACT： | OBJECTIVE To report a case of visual abnormalities induced by oxaliplatin， and provide a reference for clinical medication safety. METHODS Clinical pharmacists conducted the pharmaceutical care for a colon cancer patient who developed visual abnormalities during treatment with oxaliplatin. After the patient experienced two episodes of visual abnormalities in the first chemotherapy cycle， the pharmacists recommended suspending oxaliplatin and reducing its dose in the next cycle. When visual symptoms persisted in the second cycle， they recommended permanent discontinuation of oxaliplatin. Concurrently， they provided medication education to the patient and family. Using Naranjo’s Adverse Drug Reaction Probability Scale， the pharmacists assessed the correlation between oxaliplatin and the visual abnormalities， and analyzed the characteristics of this adverse reaction. RESULTS & CONCLUSIONS The physician adopted the clinical pharmacists’ recommendations. After discontinuation of the drug， the patient’s vision gradually returned to normal. The correlation between oxaliplatin and visual abnormalities was assessed as “probable”. Oxaliplatin-induced visual abnormalities are relatively rare and often occur within the first three cycles of treatment. Most patients recover their vision within two weeks after discontinuation， while a small number may progress to permanent visual impairment. Clinical pharmacist ensured the patient’s medication safety by evaluating the correlation between oxaliplatin and visual abnormalities， adjusting medication regimens， providing pharmaceutical care and medication education， and providing other pharmaceutical services. |
| 期刊： | 2025年第36卷第20期 |
| 作者： | 张扬；陈树和；高越 |
| AUTHORS： | ZHANG Yang，CHEN Shuhe，GAO Yue |
| 关键字： | 奥沙利铂；不良反应；视觉异常；临床药师；药学监护 |
| KEYWORDS： | oxaliplatin； adverse drug reactions； visual abnormalities； clinical pharmacist； pharmaceutical care |
| 阅读数： | 5 次 |
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