Anticoagulation therapy analysis and pharmaceutical care for a breast cancer patient with pulmonary thromboem-bolism accompanied by multiple comorbidities
- VernacularTitle:1例肺血栓栓塞症伴多种合并症乳腺癌患者的抗凝治疗分析与药学监护
- Author:
Meng HUO
1
,
2
;
Qijian CHENG
3
;
Jiayuan LIN
2
Author Information
1. Dept. of Pharmacy，the First Affiliated Hospital of Wenzhou Medical University，Zhejiang Wenzhou 325000，China
2. Dept. of Pharmacy，Ruijin Hospital，Shanghai Jiao Tong University School of Medicine，Shanghai 201801，China
3. Dept. of Pulmonary & Critical Care Medicine，Ruijin Hospital，Shanghai Jiao Tong University School of Medicine，Shanghai 201801，China
- Publication Type:Journal Article
- Keywords:
pulmonary thromboembolism;
severe thrombocytopenia;
antiphospholipid syndrome;
anticoagulation;
clinical
- From:
China Pharmacy
2025;36(2):219-224
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To provide a reference for anticoagulant therapy and pharmaceutical care of the breast cancer patient with pulmonary thromboembolism （PTE） accompanied by multiple comorbidities. METHODS Clinical pharmacists participated in the diagnosis and treatment of a breast cancer patient with PTE accompanied by severe thrombocytopenia and suspected antiphospholipid syndrome secondary to systemic lupus erythematosus， and provided personalized pharmaceutical care as developing individualized anticoagulation plans and monitoring patient bleeding. For the occurrence of PTE， the clinical pharmacist recommended stopping all breast cancer drugs. The clinical pharmacists also cleared that severe thrombocytopenia was not the absolute contraindication for anticoagulant treatment and suggested fondaparinux sodium as the initial anticoagulation regimen. Further， warfarin was recommended as the long-term anticoagulation regimen with a recommended treatment course of at least 3-6 months by the clinical pharmacists. Whether to continue indefinite anticoagulation therapy was based on the results of the antiphospholipid antibodies after 12 weeks combined with the tumor treatment regimen. RESULTS The physicians adopted the advice of the clinical pharmacists. After treatment， the patient’s blood phlegm and anhelation disappeared and the platelets returned to normal. The patient was allowed to be discharged with medication. CONCLUSIONS Taking the “anticoagulation-bleeding” as the starting point， the clinical pharmacists develop individualized medication plans for patients so as to ensure the safety and effectiveness of medication in the patient by providing pharmaceutical care， such as analyzing the causal relationship between breast cancer treatment-related drugs and PTE， assessing the risk of bleeding and thrombus recurrence， and monitoring patients’ bleeding symptoms and signs and coagulation indicators.
