免疫抑制療法を施行した重症再生不良性貧血患者に対する薬剤管理指導 : 症例の検討

概要

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We report 2 patients who received medical guidance during immunosuppressive therapy involving the administration of antithymocyte globulin (ATG) and cyclosporin A (CyA) for complicated aplastic anemia. In case 1, during the second administration of ATG, side effects manifested as allergic reaction and serum sickness. In case 2, the side effects after the first administration of ATG were the same as those in case 1. An antimycotic drug that can increase the blood concentration of CyA was also administered in case 1. The BUN level, which is a marker of renal function, was slightly elevated. In both cases, drug compliance for CyA was good, and the trough blood concentration of CyA remained within the objective concentration. Levels of leucocyte, neurophils and thrombocytes tended to the recover after combined administration of both drugs in the 2 patients. However, the patient' s quality of life (QOL) decreased remarkably due to a deterioration of the stomatitis, since the host was immunocompromised. The patient's QOL improved by the administration of narcotic analgesics. In case 2, the stomatitis did not worsen, since infection was prevented by the use of a clean room and care of the oral cavity. This study suggests that appropriate pharmaceutical care during immunosuppressive therapy contributes to QOL maintenance in patients with aplastic anemia.
日本医療薬学会の論文
2003-08-10