Maxwell Cathy, Swift Regina, Goode Melissa, Doane Lois, Rogers Miriam
Clin J Oncol Nurs. 2003 Jul-Aug;7(4):403-8. doi: 10.1188/03.CJON.403-408.
The knowledge and training of nursing staff is essential for the safety and comfort of patients receiving i.v. therapies. The use of i.v. bisphosphonates as an adjunct to standard antineoplastic therapies in patients with advanced cancer is becoming widespread. Zoledronic acid and pamidronate (Zometa and Aredia, Novartis Pharmaceuticals Corporation, East Hanover, NJ) are nitrogen-containing bisphosphonates. Pamidronate has been the standard of care for patients with osteolytic bone lesions from breast cancer or multiple myeloma. However, zoledronic acid, which has demonstrated increased potency and a broad clinical utility, is emerging as the new standard of care. In addition to treating hypercalcemia of malignancy, zoledronic acid is approved for treating patients with bone metastases (osteolytic or osteoblastic) from a wide range of solid tumors, including breast, prostate, and lung cancers, or osteolytic bone lesions from multiple myeloma. Zoledronic acid (4 mg via a 15-minute infusion) has a safety profile comparable with pamidronate (90 mg via a two-hour infusion) and has demonstrated comparable or superior efficacy to that of pamidronate in every patient population tested. The shorter infusion time of zoledronic acid compared with that of pamidronate may provide added convenience, but safety guidelines should be followed for all i.v. bisphosphonate therapies. These guidelines and nursing care of patients receiving i.v. bisphosphonates are reviewed.
护理人员的知识和培训对于接受静脉治疗的患者的安全与舒适至关重要。静脉注射双膦酸盐作为晚期癌症患者标准抗肿瘤治疗的辅助手段，其应用正日益广泛。唑来膦酸和帕米膦酸（诺华公司的择泰与阿可达，新泽西州东哈嫩）是含氮双膦酸盐。帕米膦酸一直是乳腺癌或多发性骨髓瘤溶骨性骨病变患者的护理标准。然而，已证明效力更强且临床应用广泛的唑来膦酸正成为新的护理标准。除了治疗恶性肿瘤引起的高钙血症外，唑来膦酸还被批准用于治疗多种实体瘤（包括乳腺癌、前列腺癌和肺癌）的骨转移（溶骨性或成骨性）患者，或多发性骨髓瘤的溶骨性骨病变患者。唑来膦酸（4毫克，静脉输注15分钟）的安全性与帕米膦酸（90毫克，静脉输注2小时）相当，并且在所有测试的患者群体中已证明其疗效与帕米膦酸相当或更优。与帕米膦酸相比，唑来膦酸的输注时间更短，可能会带来更多便利，但所有静脉注射双膦酸盐治疗都应遵循安全指南。本文对这些指南以及接受静脉注射双膦酸盐治疗的患者的护理进行了综述。
