Pharmaceutical Care of One Patient with Severe Acute Left Heart Failure Induced by Low-dose Epirubicin

doi:10.19803/j.1672-8629.2021.12.20

Abstract

Abstract: Objective To study the importance of clinical pharmacists monitoring adverse reactions among patients under chemotherapy by reviewing the process of treating one patient with severe acute left heart failure induced by low-dose epirubicin.Methods Clinical pharmacists participated in the adjustment of chemotherapy drugs, made correlation analysis, analyzed the risk factors for adverse reactions, and conducted comprehensive pharmaceutical monitoring for a patient with severe heart failure caused by epirubicin at a cumulative dose of only 51 mg/m². Results Clinical pharmacists assisted physicians in making quick judgment and dealing with adverse reactions, analyzed potential risk factors, and removed obstacles to subsequent chemotherapy.Conclusion Anthracyclines have no absolute“safe dose”. Clinicians have to be alert to serious adverse reactions in elderly patients with liver dysfunction, hypoproteinemia, hypercalcemia, and low body weight. Clinical pharmacists can help physicians monitor patients under chemotherapy to prevent serious adverse reactions.

Key words: epirubicin, acute left heart failure, adverse drug reaction, pharmaceutical care

CLC Number:

R969.3

LI Li, ZHANG Dan, ZHOU Nan, ZHANG Peng, ZHU Yaning. Pharmaceutical Care of One Patient with Severe Acute Left Heart Failure Induced by Low-dose Epirubicin[J]. Chinese Journal of Pharmacovigilance, 2021, 18(12): 1189-1191.

References

[1] Siegel RL, Fedewa SA, Miller KD, et al.Cancer statistics for Hispanics/Latinos[J]. CA Cancer J Clin, 2015, 65(6): 457-480.
[2] CSCO, CHS.Expert consensus of preventing heart toxicity by anthracycline in China(version 2013)[J]. Chinese Clinical Oncology(临床肿瘤学杂志), 2013, 18(10): 925-934
[3] Banke A, Fosbøl EL, Møller JE, et al.Long-term effect of epirubicin on incidence of heart failure in women with breast cancer: insight from a randomized clinical trial[J]. Eur J Heart Fail, 2018, 20(10): 1447-1453.
[4] Narod SA, Dent RA, Foulkes WD.CCR 20th anniversary commentary:triple-negative breast cancer in 2015-Still in the Ballpark[J]. Clin Cancer Res, 2015, 21(17): 3813-3814.
[5] Sun Y, Shi YK.Handbook of Clinical Oncology(临床肿瘤内科手册)[M]. 5th ed. Beijing: People's Medical Publishing House, 2013: 433.
[6] Wojnowski L, Kulle B, Schirmer M, et al.NAD(P)H oxidase and multidrug resistance protein genetic polymorphisms are associated with doxorubicin-induced cardiotoxicity[J]. Circulation, 2005, 112(24): 3754-3762.
[7] Simunek T, sterba M, Popelova O, et a1. Anthracycline-induced cardiotoxicity: overview of studies examining the roles of oxidative stress and free cellular iron[J]. Pharmacol Rep, 2009, 61(1): 154-171.
[8] Yang M, Lu J, Mu JJ, et al.A systematic review of Shengmai injection in the prevention and treatment of cardiotoxicity of anthracycline antitumor drugs[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2012, 9(11): 666-669.
[9] Shi Y, Fan DF, Hou BL, et al.The mechanism of action of adriamycin-induced cardiotoxicity and research progress in prevention and treatment of traditional Chinese medicine[J]. Xinjiang Journal of Traditional Chinese Medicine(新疆中医药), 2019, 37(1): 113-116.
[10] Drafts BC, Twomley KM, D"Agostino R, et al. Low to moderate dose anthracycline-based chemotherapy is associated with early noninvasive imaging evidence of subclinical cardiovascular disease[J]. JACC Cardiovasc Imag, 2013, 6(8): 877-885.
[11] Su HG.Adverse reactions and influencing factors in the application of tumor chemotherapy drugs[J]. Chinese Journal of Modern Drug Application(中国现代药物应用), 2017, 11(9): 108-110.
[12] Zhai SJ.Observation on the characteristics and risk factors of heart failure in critically ill patients[J].Electronic Journal of Integrated Traditional Chinese and Western Medicine Cardiovascular Diseases(中西医结合心血管病电子杂志), 2019, 7(2): 48.
[13] Lauritsen J, Gustafsson F, Abdulla J.Characteristics and Long-term prognosis of patients with heart failure and mid-range ejection fraction compared with reduced and preserved ejection fraction: a systematic review and meta-analysis[J]. ESC Heart Fail, 2018, 5(4): 685-694.
[14] Li P.The influence of BMI index on the prognosis of patients with chronic heart failure after myocardial infarction[D]. Taiyuan: Shanxi Medical University, 2019.
[15] Arun B, Akar U, Gutierrez-Barrera AM, et al.The PARP inhibitor AZD2281 (Olaparib) induces autophagy/mitophagy in BRCA 1 and BRCA 2 mutant breast cancer cells[J]. Int J Oncol, 2015, 47(1): 262-268.
[16] Wang HL. Clinical Pharmacology(临床药理学)[M]. Beijing: Higher Education Press, 2015: 33.