药师在药物相关性颌骨坏死患者临床诊疗及监护中的作用
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摘要
临床药师通过参与3例临床双膦酸盐类药物致颌骨坏死(BRONJ)患者的诊疗过程,进行药学问诊,协助医师及时判断确诊病因,避免出现误诊、漏诊,也分析了如何根据患者伴发疾病的情况进行双膦酸盐药物治疗方案的调整,为如何帮助患者制定更合理、有效、有针对性的联合用药方案提供了思路。医师采纳临床药师的建议后,进行了双膦酸盐治疗方案的调整;临床药师也为患者如何继续药物治疗进行了宣教。患者通过治疗,情况好转出院,门诊随访。在BRONJ患者的临床诊疗过程中,临床药师对可能发生的BRONJ进行判断,参与双膦酸盐治疗方案的调整,与医师进行了良好而有效的沟通,并给予医师相应的建议,为临床安全、合理和有效的药物治疗提供了一定的参考。
This paper explores the role of clinical pharmacists in the clinical diagnosis and treatment of patients with bisphosphonate-related osteonecrosis of the jaw(BRONJ). Clinical pharmacists participated in the therapy for 3 patients with BRONJ, helped surgeons to diagnose BRONJ through pharmacologic inquiry, suggested changes and substitution treatments of bisphosphonate. Oral surgeons adopted the suggestions of the clinical pharmacist, and the patient was recovered and discharged ouring to clinical pharmacist's participation in the drug therapy, and individualized therapy to ensure safe and rational use of drugs.
This paper explores the role of clinical pharmacists in the clinical diagnosis and treatment of patients with bisphosphonate-related osteonecrosis of the jaw(BRONJ). Clinical pharmacists participated in the therapy for 3 patients with BRONJ, helped surgeons to diagnose BRONJ through pharmacologic inquiry, suggested changes and substitution treatments of bisphosphonate. Oral surgeons adopted the suggestions of the clinical pharmacist, and the patient was recovered and discharged ouring to clinical pharmacist's participation in the drug therapy, and individualized therapy to ensure safe and rational use of drugs.
引文
[1]Marx RE.Pamidronate(Aredia)and zoledronate(Zometa)induced avascular necrosis of the jaws:a growing epidemic[J].J Oral Maxillofac Surg,2003,61(9):1115-1117.
[2]Advisory Task Force on Bisphosphonate-Related Ostenonecrosis of the Jaws,American Association of Oral and Maxillofacial Surgeons.American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws[J].J Oral Maxillofac Surg,2007,65(3):369-376.
[3]Ruggiero SL,Dodson TB,Assael LA,et al.American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws-2009 update[J].J Oral Maxillofac Surg,2009,67(5 Suppl):2-12.
[4]Gill SB,Valencia MP,Sabino ML,et al.Bisphosphonate-related osteonecrosis of the mandible and maxilla:clinical and imaging features[J].J Comput Assist Tomogr,2009,33(3):449-454.
[5]张学伟,刘浩,陈瑞扬,等.双膦酸盐相关性颌骨坏死9例临床分析[J].中国口腔颌面外科杂志,2016,14(5):449-454.
[6]Borromeo GL,Tsao CE,Darby IB,et al.A review of the clinical implications of bisphosphonates in dentistry[J].Aust Dent J,2011,56(1):2-9.
[7]Vandone AM,Donadio M,Mozzati M,et al.Impact of dental care in the prevention of bisphosphonate-associated osteonecrosis of the jaw:a single-center clinical experience[J].Ann Oncol,2012,23(1):193-200.
[8]Abu-Id MH,Warnke PH,Gottschalk J,et al.“Bisphossy jaws”-high and low risk factors for bisphosphonate-induced osteonecrosis of the jaw[J].J Craniomaxillofac Surg,2008,36(2):95-103.
[9]Ruggiero SL.Diagnosis and staging of medication-related osteonecrosis of the jaw[J].Oral Maxillofac Surg Clin North Am,2015,27(4):479-487.
[10]房桂珍,李为民.双膦酸盐类药物引起的下颌骨坏死[J].中国肿瘤临床,2007,34(18):1069-1071.
[11]贺捷,邱蔚六.二膦酸盐与颌骨骨坏死[J].中国口腔颌面外科杂志,2010,8(4):370-375.
[12]Marx RE,Sawatari Y,Fortin M,et al.Bisphosphonateinduced exposed bone(osteonecrosis/osteopetrosis)of the jaws:risk factors,recognition,prevention and treatment[J].J Oral Maxillofac Surg,2005,63(11):1567-1575.
[13]Diel IJ,Fogelman I,Al-Nawas B,et al.Pathophysiology,risk factors and management of bisphosphonate-associated osteonecrosis of the jaw:is there a diverse relationship of aminoand non-aminobisphosphonates?[J].Crit Rev Oncol Hematol,2007,64(3):198-207.
[14]Wilkinson GS,Kuo YF,Freeman JL,et al.Intravenous bisphosphonate therapy and inflammatory conditions or surgery of the jaw:a population-based analysis[J].J Natl Cancer Inst,2007,99(13):1016-1024.
[15]宋志强,董伟,阴露佳,等.沙利度胺对双膦酸盐相关颌骨坏死的影响[J].南方医科大学学报,2015,35(8):1084-1089.
[2]Advisory Task Force on Bisphosphonate-Related Ostenonecrosis of the Jaws,American Association of Oral and Maxillofacial Surgeons.American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws[J].J Oral Maxillofac Surg,2007,65(3):369-376.
[3]Ruggiero SL,Dodson TB,Assael LA,et al.American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws-2009 update[J].J Oral Maxillofac Surg,2009,67(5 Suppl):2-12.
[4]Gill SB,Valencia MP,Sabino ML,et al.Bisphosphonate-related osteonecrosis of the mandible and maxilla:clinical and imaging features[J].J Comput Assist Tomogr,2009,33(3):449-454.
[5]张学伟,刘浩,陈瑞扬,等.双膦酸盐相关性颌骨坏死9例临床分析[J].中国口腔颌面外科杂志,2016,14(5):449-454.
[6]Borromeo GL,Tsao CE,Darby IB,et al.A review of the clinical implications of bisphosphonates in dentistry[J].Aust Dent J,2011,56(1):2-9.
[7]Vandone AM,Donadio M,Mozzati M,et al.Impact of dental care in the prevention of bisphosphonate-associated osteonecrosis of the jaw:a single-center clinical experience[J].Ann Oncol,2012,23(1):193-200.
[8]Abu-Id MH,Warnke PH,Gottschalk J,et al.“Bisphossy jaws”-high and low risk factors for bisphosphonate-induced osteonecrosis of the jaw[J].J Craniomaxillofac Surg,2008,36(2):95-103.
[9]Ruggiero SL.Diagnosis and staging of medication-related osteonecrosis of the jaw[J].Oral Maxillofac Surg Clin North Am,2015,27(4):479-487.
[10]房桂珍,李为民.双膦酸盐类药物引起的下颌骨坏死[J].中国肿瘤临床,2007,34(18):1069-1071.
[11]贺捷,邱蔚六.二膦酸盐与颌骨骨坏死[J].中国口腔颌面外科杂志,2010,8(4):370-375.
[12]Marx RE,Sawatari Y,Fortin M,et al.Bisphosphonateinduced exposed bone(osteonecrosis/osteopetrosis)of the jaws:risk factors,recognition,prevention and treatment[J].J Oral Maxillofac Surg,2005,63(11):1567-1575.
[13]Diel IJ,Fogelman I,Al-Nawas B,et al.Pathophysiology,risk factors and management of bisphosphonate-associated osteonecrosis of the jaw:is there a diverse relationship of aminoand non-aminobisphosphonates?[J].Crit Rev Oncol Hematol,2007,64(3):198-207.
[14]Wilkinson GS,Kuo YF,Freeman JL,et al.Intravenous bisphosphonate therapy and inflammatory conditions or surgery of the jaw:a population-based analysis[J].J Natl Cancer Inst,2007,99(13):1016-1024.
[15]宋志强,董伟,阴露佳,等.沙利度胺对双膦酸盐相关颌骨坏死的影响[J].南方医科大学学报,2015,35(8):1084-1089.