中国药物警戒 ›› 2025, Vol. 22 ›› Issue (3): 346-348.
DOI: 10.19803/j.1672-8629.20240473

• 安全与合理用药 • 上一篇    下一篇

氟尿嘧啶注射液致结肠癌患者中枢神经毒性1例分析

敏琼1,2, 李鹏2, 3, 戴晓雁1, 范春玲1, 尤海生2,*   

  1. 1甘肃省肿瘤医院药学部,甘肃 兰州 730000;
    2西安交通大学第一附属医院药学部,陕西 西安 710000;
    3杨陵区揉谷卫生院药剂科,陕西 咸阳 712000
  • 收稿日期:2024-08-12 出版日期:2025-03-15 发布日期:2025-03-17
  • 通讯作者: *尤海生,男,博士,副主任药师,临床药理学。E-mail: haishengyou77@163.com
  • 作者简介:敏琼,女,硕士,主管药师,临床药学。
  • 基金资助:
    兰州市科技发展计划项目（2023-ZD-72）

One Case of Neurotoxicity Caused by Fluorouracil Injection in a Patient with Metastatic Colorectal Cancer

MIN Qiong1,2, LI Peng2,3, DAI Xiaoyan1, FAN Chunling1, YOU Haisheng2,*   

  1. 1Department of Pharmacy, Gansu Provincial Cancer Hospital, Lanzhou Gansu 730000, China;
    2Department of Pharmacy, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an Shaanxi 710000, China;
    3Department of Pharmacy, Yangling District Rougu Hospital, Xianyang Shaanxi 712000, China
  • Received:2024-08-12 Online:2025-03-15 Published:2025-03-17

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摘要： 目的 分析氟尿嘧啶腹腔热灌注联合静脉化疗致中枢神经毒性病例,为临床安全合理用药提供参考。方法 以1例结肠癌患者出现中枢神经毒性为例,分析并采用不良反应关联性评价方法评估氟尿嘧啶注射液与中枢神经毒性的关联性。结果 该患者出现中枢神经毒性可能与氟尿嘧啶有关,考虑为氟尿嘧啶过暴露导致的急性中枢神经毒性,后续治疗减少氟尿嘧啶用量后患者未再发生不良反应。结论 氟尿嘧啶腹腔热灌注和静脉化疗联合应用时要考虑药物剂量的累积效应,应适当降低药物剂量或换用其他不同机制的药物,减少发生全身不良反应的风险。

关键词: 氟尿嘧啶, 注射液, 腹腔热灌注, 中枢神经毒性, 结肠癌, 药品不良反应

Abstract: Objective To analyze one case of neurotoxicity caused by fluorouracil. Methods One case of acute neurotoxicity was investigated. The cause of neurotoxicity was identified by analyzing the diagnosis and treatment of the patient while the suspected drug was evaluated via causality assessment of adverse event. Results Neurotoxicity in this patient was considered to have been caused by the rising dose of fluorouracil. After subsequent treatment at a reduced dose of fluorouracil, the patient did not experience any more adverse reactions. Conclusion Toxicity can be increased when fluorouracil is used in intraperitoneal perfusion chemotherapy and intravenous chemotherapy at the same time. In order to decrease the risk of toxicity, clinicians ought to prescribe a lower dosage or choose a different drug.

Key words: Fluorouracil, Injection, Intraperitoneal Perfusion Chemotherapy, Neurotoxicity, Metastatic Colorectal Cancer, Adverse Drug Reactions

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