McCune-Albright综合征患儿超说明书用药并文献复习

探讨甲羟孕酮、来曲唑和唑来膦酸超说明书用药的合理性。方法：1例6岁8个月男性患儿,出生时发现左臀部咖啡样色斑,4岁颅面部畸形,5岁时出现第二性征发育,同时出现骨龄超前,诊断为"McCune-Albright综合征"。入院后,相继给予甲羟孕酮片（4 mg bid po）+来曲唑片（1.25 mg qd po）+唑来膦酸注射液（3 mg once iv gtt）+碳酸钙片（250 mg qd po）和维生素AD滴剂（胶囊型）（1粒qdpo）治疗。结果：经过23 d的对症治疗后,患者一般情况及症状稳定,要求出院。结论：临床药师参与患者的药物治疗过程,对唑来膦酸和甲羟孕酮、来曲唑的超说明书用药有了进一步的认识,提高了药物的治疗水平。临床药师通过参与临床实践,协助医师参与患者的用药监护,提高药物治疗的安全性。

Off-label Drug Use in A Child with McCune-Albright Syndrome and Its Literature Review

Objective:To investigate the rationality of off-label drug use of medroxyprogesterone, letrozol and zoledronate. Methods:A male patient aged 6 years and 8 months was found to have coffee-like spots in the left hip at birth, cranial facial deformity at the age of four, secondary sexual development and advanced bone age at the age of 5 and was diagnosed as "McCune-Albright Syndrome". After admission, he was given medroxyprogesterone (4 mg bid po) + letrozole (1.25 mg qd po) + zoledronate (1.25 mg qd po) + calcium carbonate (250 mg qd po) and vitamin AD (capsule) (1pill qd po). Results:After 23 days of treatment, the general situation and symptoms of the patient were stable and the patient required to be discharged. Conclusion:Through participating in drug therapy for the patient, clinical pharmacists acquired further understanding on off-label use of zoledronate and medroxyprogesterone, letrozole to improve the level of medication. Through participating in clinical practice, clinical pharmacists assisted physicians in monitoring medication, which improved the safety of medication.