Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
Expert Opin Drug Saf. 2022 Jan;21(1):107-119. doi: 10.1080/14740338.2021.1965990. Epub 2021 Aug 12.
Oral antineoplastic agents (OAAs) are high-risk drugs that may increase the risk of bleeding, difficulty in wound healing, or produce alterations in coagulation and/or platelet aggregation. These aspects had to be highly considered throughout the entire perioperative process. Our aim was to create a comprehensive management medication guide based on reconciliation and dose adjustment recommendations for OAAs in patients undergoing a surgical intervention.
We analyzed all OAAs approved by the EMA in November 2020. We assessed data related to dose adjustment, drug reconciliation, coagulation disturbances, or anticoagulant interactions from the FDA and EMA summary of product characteristics.
We analyzed 67 OAAs. We identified that 51 (76.2%) OAAs can produce alteration in the platelet count, 12 (17.9%) affect the wound healing and recovery process, and 32 (47.8%) require control and monitoring in case of combination with anticoagulants. Only 13 (19.4%) OAAs, most of them antiangiogenics, have specific recommendations for temporary suspension before surgery.
Most OAAs require perioperative monitoring. This review can serve as an easy (simple, effective) tool to help healthcare professionals involved in patient care to manage OAAs during the perioperative process.
口服抗肿瘤药物（OAAs）是高危药物，可能会增加出血、伤口愈合困难或导致凝血和/或血小板聚集改变的风险。在整个围手术期过程中，这些方面都需要高度考虑。我们的目的是根据 EMA 在 2020 年 11 月批准的所有 OAAs，创建一个综合管理药物指南，包括手术干预患者的 OAAs 剂量调整建议。
我们分析了所有在 2020 年 11 月获得 EMA 批准的 OAAs。我们评估了来自 FDA 和 EMA 产品特性摘要中与剂量调整、药物协调、凝血紊乱或抗凝剂相互作用相关的数据。
我们分析了 67 种 OAAs。我们发现 51 种（76.2%）OAAs 会导致血小板计数改变，12 种（17.9%）影响伤口愈合和恢复过程，32 种（47.8%）在与抗凝剂联合使用时需要控制和监测。只有 13 种（19.4%）OAAs，大多数是抗血管生成药物，有在手术前临时停药的具体建议。
大多数 OAAs 需要围手术期监测。本综述可作为一种简便（简单、有效）的工具，帮助参与患者护理的医疗保健专业人员在围手术期管理 OAAs。
