Pharmaceutical intervention on a complicated patient with oophoroma, lymphatic tuberculosis and regular hemodialysis / 中国药学杂志

ABSTRACT

OBJECTIVE: To carry out pharmaceutical intervention on a complicated patient with oophoroma, lymphatic tuberculosis and regular hemodialysis to achieve better therapeutic effect. METHODS: Clinical pharmacists developed anti-tuberculosis and anti-tumor schemes, optimized carboplatin dosage, determined free platinum concentrations, calculated AUG of platinum and monitored adverse drug effect by using their pharmaceutical expertise. RESULTS: Hospital-wide consultation recommended this patient with prior anti-TB treatment, and continue with ovarian cancer chemotherapy after somewhat lymphatic tuberculosis is controlled. The final anti-TB treatment scheme is rifampicin 0.45 g, once daily, morning empty stomach; isoniazid, 0.3 g, once daily, administrated after dialysis on dialysis day; ethambutol, 0.75 g, administrated after each dialysis. The first course of anti-tumor schemes is paclitaxel 0.15 g·m-2 and carboplatin 0.15 g calculated according to Calvert formula, dialysis was carried 24 h later and kept 3 h. Then determined free platinum concentrations, and calculated out the following 2nd-4th courses of anti-tumor treatment, which is paclitaxel 0.15 g·m-2 and carboplatin 0.166 g. The patient had no significant adverse reactions throughout the course of therapy, and anti-tuberculosis and anti-tumor treatment achieved good effect and well tolerance by patients. CONCLUSIONS: According to pharmacokinetic and pharmacodynamic characteristics of the drug combined with patient pathophysiological conditions, clinical pharmacist designs the best treatment schemes for patients, prevents adverse reactions and held treatment monitoring. This patient can get the best treatment as a result.