Lohr Lisa K, Blake Kimball T, Chan Cindy M, Sturm Sabrina, Walsh Gavyn T
From M Health/Fairview Pharmacy Services, Minneapolis, Minnesota.
J Adv Pract Oncol. 2023 Jul;14(5):419-438. doi: 10.6004/jadpro.2023.14.5.7. Epub 2023 Jul 1.
The use of oral anticancer treatments is widespread and vital to modern cancer treatment. Novel oral chemotherapy and targeted therapy treatments continue to receive US Food and Drug Administration approval every year, making knowledge of these agents a necessity for practitioners working in oncology. Many oral anticancer agents are prone to drug interactions that can contribute to adverse effects and decrease therapy efficacy. Potential drug-drug interactions include (1) interactions with CYP3A4 inhibitors and inducers, (2) interactions related to gastric acid suppression, (3) interactions related to prolongation of the cardiac QT interval, (4) interactions related to anticoagulant medications, and (5) drug-food and drug-herb interactions. Identifying potential drug interactions and appropriately managing them is key to preventing adverse effects and ensuring maximum efficacy while on oral anticancer therapy. Management of adverse effects increases patient compliance, ensures medication safety, and allows patients to remain on therapy. This article discusses the mechanisms of interactions and types of interacting medications. Specific recommendations are discussed.
口服抗癌治疗药物的应用广泛,对现代癌症治疗至关重要。新型口服化疗药物和靶向治疗药物每年都持续获得美国食品药品监督管理局的批准,这使得肿瘤学领域的从业者必须了解这些药物。许多口服抗癌药物易于发生药物相互作用,这可能导致不良反应并降低治疗效果。潜在的药物相互作用包括:(1)与CYP3A4抑制剂和诱导剂的相互作用;(2)与胃酸抑制相关的相互作用;(3)与心脏QT间期延长相关的相互作用;(4)与抗凝血药物相关的相互作用;以及(5)药物与食物和药物与草药的相互作用。识别潜在的药物相互作用并进行适当管理是预防不良反应、确保口服抗癌治疗达到最大疗效的关键。不良反应的管理可提高患者的依从性、确保用药安全,并使患者能够继续接受治疗。本文讨论了相互作用的机制以及相互作用药物的类型,并给出了具体建议。