两名过量服用胺的患者在没有尿素三酸盐的情况下成功治疗
Chantal Jar Kats1, Anouk Jochems2, Frank Jf Jeurissen2
1Department of Hospital Pharmacy, Haaglanden Medisch Centrum, The Hague, The Netherlands.
概括
尿素三酸盐被考虑用于两名过量服用5-甲 (5-FU) 的患者,但由于有效性和成本效益的证据不足,最终没有给药. 提供了最好的支持性护理,其中一名患者经历了轻度毒性和完全康复.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 临床毒理学 临床毒理学
背景情况:
- 由于输液速度加速,两名患者经历了5-甲 (5-FU) 过量服用.
- 尿素三酸盐是5-FU毒性的潜在解药,被考虑用于这两名患者.
- 以前的报道集中在尿素三酸盐在确定的毒性中的使用,而不是过量预防.
研究的目的:
- 描述两个考虑治疗尿素三酸盐的5 - FU过量用药的病例.
- 在这些特定的过量情况中,提出避免尿素三酸盐的合理理由.
- 突出需要进一步证据关于尿素三酸盐的临床和成本效益.
主要方法:
- 病例报告详细介绍了两名接受超治疗剂量5-FU的患者.
- 评估了患者的二皮里米丁脱酶 (DPYD) 基因型,并发现正常.
- 两位患者都接受了最佳支持性护理和重症监护病房监测.
主要成果:
- 第一个患者在2小时内服用1200mg/m2的5-FU,并没有产生毒性.
- 第二位患者在13小时内服用2600mg/m2的5-FU,经历了毒性,但完全康复.
- 两位患者都没有接受尿素三酸盐.
结论:
- 拒绝氨酸三酸盐的决定是基于其临床和成本效益的有限证据以及在欧盟未注册的证据.
- 需要进行进一步的比较研究,以确定尿素三酸盐的附加价值与氧胺过量后的最佳支持性护理相比.
- 为了指导治疗决策,需要在胺过量后具有可靠的毒性预测指标.
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