临床药师参与阿帕替尼致肾小球损害治疗实践

目的 为发生甲磺酸阿帕替尼致肾小球损害的小细胞肺癌患者的用药监护提供参考。方法 对1例口服甲磺酸阿帕替尼片后出现肾小球损害患者的临床资料进行回顾性分析，结合临床药学专业知识，从患者出现肾脏损害的原因、治疗措施等方面进行分析，并复习相关文献，提出口服阿帕替尼出现肾脏损害的解决措施，实施全程药学监护。结果 甲磺酸阿帕替尼引起的肾小球损害可能与其导致内皮细胞损伤有关，出现肾脏损害后应及时停药，并根据不良反应缓解程度调整剂量，临床药师参与后患者肾脏损伤改善明显。结论 阿帕替尼导致的肾小球损害较少见，在用药过程中临床药师需注意监护，及时调整用药方案并给予对症治疗，减少不良反应的发生率。

Practice of Clinical Pharmacists Participating in Renal Glomerular Damage Induced by Apatinib

OBJECTIVE To provide reference for pharmaceutical care of apatinib mesylate tablets induced renal glomerular damage in small cell lung cancer patients. METHODS The clinical data of a patient with renal glomerular damage after oral administration of apatinib was analyzed retrospectively. Combined with professional knowledge of clinical pharmacy, the causes of kidney damage and treatment measures was analyzed. Relevant literatures were reviewed, the kidney damage caused by oral administration of apatinib was proposed and the whole process of pharmaceutical care was implemented. RESULTS The renal glomerular damage induced by apatinib might be related to endothelial cell injury. The drug should be discontinued promptly for renal damage, and the dosage should be adjusted according to the degree of alleviation of adverse reactions. The kidney damage of the patient with clinical pharmacist''s participation improved significantly. CONCLUSION Renal glomerular damage caused by apatinib is rare. Clinical pharmacists should strengthen the pharmaceutical care of patients using apatinib and adjust the medication plan in time to reduce the incidence of adverse reactions.