
浏览全部资源
扫码关注微信
1.湖北省中医院药事部,武汉 430061
2.湖北中医药大学附属医院药事部,武汉 430061
3.湖北省中医药研究院,武汉 430074
主管药师,硕士。研究方向:临床药学、药物警戒。 E-mail:741376551@qq.com
副主任药师,硕士。研究方向:临床药学、药事管理。E-mail:gaoyuegaoyang@126.com
收稿:2025-05-07,
修回:2025-09-15,
录用:2025-09-15,
纸质出版:2025-10-30
移动端阅览
张扬,陈树和,高越.临床药师对奥沙利铂致视觉异常患者的药学监护 [J].中国药房,2025,36(20):2577-2581.
ZHANG Yang,CHEN Shuhe,GAO Yue.Pharmaceutical care for a patient with visual abnormalities induced by oxaliplatin by clinical pharmacists[J].ZHONGGUO YAOFANG,2025,36(20):2577-2581.
张扬,陈树和,高越.临床药师对奥沙利铂致视觉异常患者的药学监护 [J].中国药房,2025,36(20):2577-2581. DOI: 10.6039/j.issn.1001-0408.2025.20.16.
ZHANG Yang,CHEN Shuhe,GAO Yue.Pharmaceutical care for a patient with visual abnormalities induced by oxaliplatin by clinical pharmacists[J].ZHONGGUO YAOFANG,2025,36(20):2577-2581. DOI: 10.6039/j.issn.1001-0408.2025.20.16.
目的
2
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
2
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
2
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。
OBJECTIVE
2
To report a case of visual abnormalities induced by oxaliplatin, and provide a reference for clinical medication safety.
METHODS
2
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
2
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.
HU H B , ZHANG J W , LI Y F , et al . Neoadjuvant chemotherapy with oxaliplatin and fluoropyrimidine versus upfront surgery for locally advanced colon cancer:the randomized,phase Ⅲ optical trial [J ] . J Clin Oncol , 2024 , 42 ( 25 ): 2978 - 2988 .
中国抗癌协会肿瘤整体评估专业委员会 , 福建省抗癌协会癌痛专业委员会 . 奥沙利铂超敏反应全程管理中国专家共识:2024年版 [J ] . 中国癌症杂志 , 2024 , 34 ( 8 ): 785 - 806 .
范宝霞 , 孔燕 , 刘宁 , 等 . 奥沙利铂相关神经系统不良事件数据挖掘与分析 [J ] . 中国药房 , 2024 , 35 ( 3 ): 348 - 352 .
HASIK P N , THOMAS C , HAZARIKA M , et al . Ocular adverse events associated with platins:a dispropor-tionality analysis of pharmacovigilance data and extensive systematic review of case reports [J ] . Expert Opin Drug Saf , 2024 , 19 : 1 - 14 .
KUBO K , KIMURA N , WATANABE R , et al . Oxaliplatin-associated amaurosis fugax [J ] . Case Rep Oncol , 2021 , 14 ( 2 ): 832 - 837 .
TUNIO M A , PHILLIPS K , BAKER P . Amaurosis fugax:a rare oxaliplatin-induced ocular toxicity:a report of three cases [J ] . Case Rep Oncol , 2022 , 15 ( 1 ): 133 - 137 .
AH-THIANE L , RAOUL J L , HIRET S , et al . Transient vision loss-a rare oxaliplatin-induced ophthalmologic side effect:a report of two cases [J ] . Case Rep Oncol , 2021 , 14 ( 1 ): 483 - 486 .
周丽情 . 奥沙利铂治疗中的神经毒性反应临床观察与预防措施 [J ] . 黑龙江中医药 , 2024 , 53 ( 5 ): 119 - 121 .
PATEL M A , MCDEVITT R L , SASSACK W , et al . Motor “freezing” with oxaliplatin [J ] . J Oncol Pharm Pract , 2021 , 27 ( 8 ): 2014 - 2017 .
JAYASRI P , STEPHEN A M , HARIGARAVELU P J . Oxaliplatin-induced papilledema:rare case report [J ] . Saudi J Ophthalmol , 2023 , 37 ( 2 ): 161 - 163 .
MATTE P , DUCREUX M . Case report:vision loss induced by capecitabine in patient with preexisting left eyes blind [J ] . Case Rep Oncol , 2023 , 16 ( 1 ): 474 - 477 .
LEE J , CHOI J , KANG M S , et al . Bilateral optic neuro-pathy in Krukenberg tumor treated with FOLFOX plus nivolumab:a case report [J ] . BMC Ophthalmol , 2025 , 25 ( 1 ): 262 .
董利森 , 王东晓 . 1例罕见的奥美拉唑致精神异常、幻视的案例分析 [J ] . 中国药物应用与监测 , 2018 , 15 ( 1 ): 58 - 61 .
MANJHI P K , SINGH M P , KUMAR M . Causality,severity,preventability and predictability assessments scales for adverse drug reactions:a review [J ] . Cureus , 2024 , 16 ( 5 ): e59975 .
LEE S , MA C , SHI Q , et al . Potential mediators of oxaliplatin-induced peripheral neuropathy from adjuvant therapy in stage Ⅲ colon cancer:findings from CALGB(alliance)/SWOG 80702 [J ] . J Clin Oncol , 2023 , 41 ( 5 ): 1079 - 1091 .
郑志鹏 , 张少如 , 沙敏 , 等 . 结肠癌中奥沙利铂治疗诱导周围神经毒性的关键基因筛选及临床意义 [J ] . 临床肿瘤学杂志 , 2024 , 29 ( 12 ): 1211 - 1216 .
YANG Y , ZHAO B , GAO X J , et al . Targeting strategies for oxaliplatin-induced peripheral neuropathy:clinical syndrome,molecular basis,and drug development [J ] . J Exp Clin Cancer Res , 2021 , 40 ( 1 ): 331 .
BRANCA J J V , CARRINO D , GULISANO M , et al . Oxaliplatin-induced neuropathy:genetic and epigenetic profile to better understand how to ameliorate this side effect [J ] . Front Mol Biosci , 2021 , 8 : 643824 .
郭昌 , 赵文韬 , 胡丰良 . 奥沙利铂神经毒性的机制及防治研究进展 [J ] . 现代中西医结合杂志 , 2020 , 29 ( 9 ): 1022 - 1026 .
FISCHER M , SCHMUTZHARD E . Posterior reversible encephalopathy syndrome [J ] . J Neurol , 2017 , 264 ( 8 ): 1608 - 1616 .
SYMEONIDIS D G , LIATSOS A D , MAZLIMOGLOU E K , et al . Posterior reversible encephalopathy syndrome associated with oxaliplatin use for pancreatic adenocarcinoma [J ] . Case Rep Oncol , 2021 , 14 ( 2 ): 838 - 844 .
SHAHI F , MAKATEB A , KHOJASTEH H , et al . Oxa-liplatin induced crystalline retinopathy [J ] . IJCMCR , 2023 , 33 ( 2 ): 1 - 4 .
GUILLAUMOT M A , CERLES O , BERTRAND H C , et al . Oxaliplatin-induced neuropathy:the preventive effect of a new superoxide dismutase modulator [J ] . Oncotarget , 2019 , 10 ( 60 ): 6418 - 6431 .
NOOR A , DESAI A , SINGH M . Reversible ocular toxi-city of oxaliplatin:a case report [J ] . Cureus , 2019 , 11 ( 5 ): e4582 .
RIMOLA V , OSTHUES T , KÖNIGS V , et al . Oxaliplatin causes transient changes in TRPM8 channel activity [J ] . Int J Mol Sci , 2021 , 22 ( 9 ): 4962 .
0
浏览量
0
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621