1.Pharmaceutical care for a case of severe dermal toxicity induced by durvalumab
Liulian JI ; Zhengbi QIN ; Pengcheng LIU ; Xiaowen DENG ; Lili LIU ; Lijuan YAO ; Tingting LIU ; Pingchen GU
China Pharmacy 2026;37(1):88-91
OBJECTIVE To provide references for the accurate identification and management of immune-related cutaneous adverse events (irCAEs) caused by durvalumab, and ensuring safe clinical drug use. METHODS Clinical pharmacists participated in the diagnosis and treatment process of a patient with gallbladder cancer who developed irCAEs caused by durvalumab. The clinical pharmacists systematically reviewed the patient’s past medical history and medication history, and assisted physicians in assessing the association between adverse drug reactions and administered drugs. Meanwhile, the clinical pharmacists conducted a graded assessment of the adverse reaction, proposed recommendations such as discontinuing durvalumab and adjusting the administration regimen of glucocorticoids, assisted physicians in restarting immunotherapy, and carried out medication education and other pharmaceutical care. RESULTS The occurrence of irCAEs in this patient was “highly likely” related to durvalumab and was classified as severe. The physicians adopted the clinical pharmacist’s opinion, and after symptomatic treatment, the patient’s skin symptoms improved, and discharged with medication. After the completion of glucocorticoid therapy for the patient, the physician restarted immunotherapy with tislelizumab, and no related adverse reactions occurred again in the patient. CONCLUSIONS Durvalumab can cause irCAEs such as severe skin maculopapular rash. In clinical practice, it is crucial to promptly identify and discontinue suspicious drugs, immediately implement effective symptomatic treatment measures, and actively resume immunotherapy to ensure the continuity and safety of the patient’s treatment.
2.Pharmacokinetic study of 3 blood-absorbed components of Xiangshao sanjie oral liquid in rats with hyperplasia of mammary gland
Yu ZHANG ; Jiaming LI ; Dan PENG ; Ruoqiu FU ; Yue MING ; Zhengbi LIU ; Jingjing WANG ; Shiqi CHENG ; Hongjun XIE ; Yao LIU
China Pharmacy 2025;36(6):680-685
OBJECTIVE To explore the pharmacokinetic characteristics of 3 blood-absorbed components of Xiangshao sanjie oral liquid in rats with hyperplasia of mammary gland (HMG). METHODS Female SD rats were divided into control group and HMG group according to body weight, with 6 rats in each group. The HMG group was given estrogen+progesterone to construct HMG model. After modeling, two groups were given 1.485 g/kg of Xiangshao sanjie oral liquid (calculated by crude drug) intragastrically, once a day, for 7 consecutive days. Blood samples were collected before the first administration (0 h), and at 5, 15, 30 minutes and 1, 2, 4, 8, 12, 24 hours after the last administration, respectively. Using chlorzoxazone as the internal standard, the plasma concentrations of ferulic acid, paeoniflorin and rosmarinic acid in rats were detected by UPLC-Q/TOF-MS. The pharmacokinetic parameters [area under the drug time curve (AUC0-24 h, AUC0-∞), mean residence time (MRT0-∞), half-life (t1/2), peak time (tmax), peak concentration (cmax)] were calculated by the non-atrioventricular model using Phoenix WinNonlin 8.1 software. RESULTS Compared with the control group, the AUC0-24 h, AUC0-∞ and cmax of ferulic acid in the HMG group were significantly increased (P<0.05); the AUC0-24 h, AUC0-∞ , MRT0-∞ , t1/2 and cmax of paeoniflorin increased, but there was no significant difference between 2 groups (P>0.05); the AUC0-24 h and MRT0-∞ of rosmarinic acid were significantly increased or prolonged (P<0.05). C ONCLUSIONS In HMG model rats, the exposure of ferulic acid, paeoniflorin and rosmarinic acid in Xiangshao sanjie oral liquid all increase, and the retention time of rosmarinic acid is significantly prolonged.
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