使用天然化合物,总的来说,补充和替代医学(CAM)的使用,在全球范围内稳步增长,这都是由于商业压力和越来越多地使用自我药疗,以及管理自己的个人健康和福祉的愿望。面临癌症诊断的患者也面临使用这些化合物的强烈压力,通常被添加到标准治疗方案中,相反,这应该完全基于诊断和治疗护理途径(DTCP)或循证医学(EBM)。这项研究介绍了两例癌症患者的临床病例,他们向在Aviano的CRO研究所建立的药学咨询服务(PCD-PharmacyClinicalDesk)提出,意大利。两名患者都在使用天然产物和处方化疗。在第一种情况下,一名55岁的女性被诊断患有双侧乳腺癌骨转移,他使用了基于地奥司明的天然化合物,七叶皂苷(或七叶皂苷)和白藜芦醇联合瑞博西尼抗癌治疗,严重ADR(中性粒细胞减少症)被确定为药物-天然产物相互作用的结果.在第二种情况下,在PCD进行了详细的药物审查后,我们避免采取治疗性治疗(使用天然化合物),这本身可能会使一名57岁的女性患有左乳多发性浸润性导管癌的化疗无效;患者计划服用含有圣约翰麦汁tin剂和柠檬香膏tin剂的天然产品,联合紫杉醇和曲妥珠单抗。此外,我们描述了采取的纠正措施,因此概述了PCD药房咨询服务活动的主要目标:第一,为了识别,报告,管理药物不良反应(ADR),第二,确定存在药物治疗本身毒性或无效的潜在风险的治疗组合。
The use of natural compounds and, in general, the use of Complementary and Alternative Medicine (CAM), is growing steadily worldwide, both due to commercial pressure and the increasing use of self-medication and the desire to manage one\'s own personal health and well-being. Patients facing a cancer diagnosis are also strongly pressured to use these compounds, which are often added to standard therapeutic regimens, that should instead be based solely on diagnostic and therapeutic care pathways (DTCP) or evidence-based medicine (EBM). This study presents two clinical cases of cancer patients who presented to the pharmaceutical consultation service (PCD-Pharmacy Clinical Desk) established at the CRO Institute in Aviano, Italy. Both patients were using natural products along with prescribed chemotherapy. In the first
case, a 55-year-old woman diagnosed with bilateral breast cancer with bone metastases, who was using natural compounds based on diosmin, escin (or aescin) and resveratrol in combination with ribociclib anticancer therapy, a severe ADR (neutropenia) was identified as a consequence of the drug-natural product interaction. In the second
case, following a detailed medication review by the PCD, we avoided taking a therapeutic treatment (with natural compounds) that in itself could potentially render chemotherapy ineffective in a 57-year-old woman with multiple infiltrating ductal carcinoma of the left breast; the patient was planning to take a natural product containing St. John\'s Wort tincture and lemon balm tincture, in combination with paclitaxel and trastuzumab. In addition, we describe the corrective actions taken, thus outlining the main objectives of the activity of the PCD\'s pharmacy counseling service: first, to identify, report, and manage adverse drug reactions (ADRs), and second, to identify therapeutic combinations that present potential risks of toxicity or ineffectiveness of the drug therapy itself.