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一名癌症患者因多种药物联用引发血清素综合征的病例研究。

A Case study of polypharmacy-induced serotonin syndrome in a cancer patient.

作者信息

Zhu Andrew, Kuhnly Nicole, Chen Leon, Dulu Alina O

机构信息

Department of Anesthesiology & Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Columbia University School of Nursing, New York, New York.

出版信息

J Am Assoc Nurse Pract. 2024 Dec 1;36(12):728-732. doi: 10.1097/JXX.0000000000001048.

Abstract

Polypharmacy in cancer care can be complex and detrimental, particularly among younger patients, who can be easily overlooked. This report showcases a 54-year-old woman with cancer, treated for dapsone-induced methemoglobinemia with methylene blue (MB), subsequently developing serotonin syndrome (SS) due to concurrent serotonin-active medications. This case highlights the critical impact of polypharmacy, emphasizing the necessity for acute care providers to diligently assess medication interactions, especially in emergencies. It underscores the importance of considering alternative treatments and the vigilant monitoring of symptoms indicative of adverse drug interactions to ensure patient safety and optimize outcomes in complex therapeutic scenarios.

摘要

癌症治疗中的多重用药可能很复杂且有害,尤其是在年轻患者中,他们很容易被忽视。本报告展示了一名54岁的癌症女性患者,因服用氨苯砜导致高铁血红蛋白血症而接受亚甲蓝(MB)治疗,随后因同时使用5-羟色胺活性药物而发生5-羟色胺综合征(SS)。该病例突出了多重用药的关键影响,强调了急症护理人员认真评估药物相互作用的必要性,尤其是在紧急情况下。它强调了考虑替代治疗方法以及密切监测表明药物不良反应的症状的重要性,以确保患者安全并在复杂的治疗场景中优化治疗效果。

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本文引用的文献

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Recommendations for diagnosis and treatment of methemoglobinemia.高铁血红蛋白血症的诊断和治疗建议。
Am J Hematol. 2021 Dec 1;96(12):1666-1678. doi: 10.1002/ajh.26340. Epub 2021 Sep 23.
9
Polypharmacy and Medication Management in Older Adults.老年人的多重用药与药物管理
Nurs Clin North Am. 2017 Sep;52(3):457-468. doi: 10.1016/j.cnur.2017.04.007.
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Plasmapheresis in severe methemoglobinemia following occupational exposure.职业暴露后重度高铁血红蛋白血症的血浆置换治疗
Transfus Apher Sci. 2017 Jun;56(3):341-344. doi: 10.1016/j.transci.2017.02.003. Epub 2017 Feb 20.

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