药品使用（化疗）

紫杉醇注射液 【功效主治】 紫杉醇注射液用于卵巢癌和乳腺癌及NSCLC的一线和二线治疗 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/ddcd872afed6f699f0776572c940abe4.png" \* MERGEFORMATINET 头颈癌食管癌精原细胞瘤复发非何金氏淋巴瘤等 【成份】 紫杉醇注射液主要成分为紫杉醇 【性状】 紫杉醇注射液为无色或淡黄色澄明粘稠液体 【用法用量】 为了预防发生过敏反应在紫杉醇治疗前 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/e8ab37108bb8aa859a8c338641e70b5d.png" \* MERGEFORMATINET 小时口服地塞米松 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b14c3f0e4b4e6048e6abfb4d5fa02771.png" \* MERGEFORMATINET mg治疗前 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/2d60d505364584b673ffdd9ae681f768.png" \* MERGEFORMATINET 小时再囗服地塞米松 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d37d83d1b6ad6d2a39c01a3b83151aee.png" \* MERGEFORMATINET mg治疗前 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d37d83d1b6ad6d2a39c01a3b83151aee.png" \* MERGEFORMATINET ～ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d37d83d1b6ad6d2a39c01a3b83151aee.png" \* MERGEFORMATINET 分钟给予苯海拉明肌注 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET mg静注西咪替丁 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b14c3f0e4b4e6048e6abfb4d5fa02771.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d37d83d1b6ad6d2a39c01a3b83151aee.png" \* MERGEFORMATINET mg或雷尼替丁 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/4f04bd4c0524b1de14cb20112b7bd678.png" \* MERGEFORMATINET mg单药剂量为 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/e99908eaa5d26752f449f9c3195524b7.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b44922b09ca1cd8767e6392a3a7de21f.png" \* MERGEFORMATINET ～ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET mg/m INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/a59b75df494c79eb9e8638d17221d6d4.png" \* MERGEFORMATINET 在G-CSF支持下剂量可达 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/758ad540b11deb0a59f99933571f90c9.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b14c3f0e4b4e6048e6abfb4d5fa02771.png" \* MERGEFORMATINET mg/m INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/8cd9b3209843fd36e3d50b4a6884c4db.png" \* MERGEFORMATINET 将紫杉醇用生理盐水或%葡萄糖盐水稀释静滴小时联合用药剂量为 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/de5572f5dd440f8812a0b3d598a41853.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/254349e857c998e91c5813d96aa79782.png" \* MERGEFORMATINET ～ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/8366c2ac68e94c4b941e0a8673522961.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/8b1c6f0afd18a909c23e8db1ed47e547.png" \* MERGEFORMATINET mg/m INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/a59b75df494c79eb9e8638d17221d6d4.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/e450cdcf73bef9bc90affd5be2ba4c50.png" \* MERGEFORMATINET ～周重复 【禁忌】 对聚氧乙基代蓖麻油过敏者禁用于中性白细胞低于 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/254349e857c998e91c5813d96aa79782.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET /MM者 【不良反应】 . 过敏反应发生率为 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/90fd33122a4215246541c61aee83e4f0.png" \* MERGEFORMATINET %其中严重过敏反应发生率为%多数为Ⅰ型变态反应现为支气管痉挛性呼吸困难荨麻疹和低血压几乎所有的反应发生在用药后最初的 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET 分钟 . 骨髓抑制为主要剂量限制性毒性表现为中性粒细胞减少血小板降低少见一般发生在用药后～ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/4f04bd4c0524b1de14cb20112b7bd678.png" \* MERGEFORMATINET 日严重中性粒细胞发生率为 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/255edaa3c498fc41a8ac9afcacfcff7e.png" \* MERGEFORMATINET %严重的血小板降低发生率为%贫血较常见 . 神经毒性周围神经病变发生率为 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/c61923418043307dbd97c5bbf6f8e0b0.png" \* MERGEFORMATINET %最常见的表现为轻度麻木和感觉异常严重的神经毒性发生率为% . 心血管毒性可有低血压和无症状的短时间心动过缓肌肉关节疼痛发生率为 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/254349e857c998e91c5813d96aa79782.png" \* MERGEFORMATINET %发生于四肢关节发生率和严重程度呈剂量依赖性 . 胃肠道反应恶心呕吐腹泻和黏膜炎发生率分别为 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/90fd33122a4215246541c61aee83e4f0.png" \* MERGEFORMATINET % INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/a124f7190c0272de5021d32f2c6f99d7.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/f2c749ca7bb66408d743a9e84d417d43.png" \* MERGEFORMATINET %和 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/edd497fbcfac6f5f892b7c7783541494.png" \* MERGEFORMATINET %一般为轻和中度 . 肝脏毒性为ALTAST和AKP升高 . 脱发发生率为 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET % . 局部反应输注药物的静脉和药物外渗局部的炎症 【注意事项】 治疗前应用地塞米松苯海拉明和H受体拮抗剂进行预处理未稀释的浓缩药液不要接触聚氯乙烯塑料器械或设备且不能进行静脉滴注稀释的药液应储藏在瓶内或塑料袋采用聚氯乙烯给药设备滴注给药期间应注意有无过敏反应及生命特征的变化 【药物相互作用】 药代动力学资料证明顺铂后给予紫杉醇注射液紫杉醇注射液清除率大约降低 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET %骨髓毒性较为严重同时应用酮康唑影响紫杉醇注射液的代谢 【贮藏】 遮光密闭 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/3353c57902ba5cdb3c376d6f425102e6.png" \* MERGEFORMATINET ℃以下保存 【包装规格】 ml∶ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b14c3f0e4b4e6048e6abfb4d5fa02771.png" \* MERGEFORMATINET mg 泰索帝(多西他赛/多西紫杉醇注射液) 【泰索帝适应症】 适用于局部晚期或转移性乳腺癌的治疗。适用于局部晚期或转移性非小细胞肺癌的治疗，即使是在以顺铂为主的化疗失败后。 【泰索帝用法用量】 静脉滴注。泰索帝的推荐剂量为每三周75mg/m2滴注一小时。为减轻体液潴留，除有禁忌症外，所有人在接受泰索帝治疗前均必须预服药物。此类药物只能包括口服糖皮质激素类，如地塞米松，在泰索帝滴注一天前服用，每天16mg(例如：每日2次，每次8mg)，持续3天。只有医生才能修改治疗方案。泰索帝不能用于中性粒细胞数目低于1500/mm3的病人。泰索帝治疗期间，如果病人发生发热性中性粒细胞减少且中性粒细胞数目持续一周以上低于500/mm3，出现严重或蓄积性皮肤反应或外周神经症状，泰索帝的剂量应酌情递减。 【泰索帝注意事项】 泰索帝必须在有癌症化疗药物应用经验的医生指导下使用。除有禁忌症外，所有病人在接受泰索帝治疗前需预服药物以减轻体液潴留的发生。中性粒细胞减少是最常见的不良反应。泰索帝治疗期间应经常对血细胞数目进行监测。在泰索帝开始滴注的最初几分钟内有可能发生过敏反应。泰索帝治疗期间可能发生外周神经毒性。可能发生体液潴留。 【泰索帝禁忌】 泰索帝禁用于以下病人:对泰索帝或吐温80有严重过敏史的病人;白细胞数目小于1500/mm3的病人；肝功能有严重损害的病人;泰索帝在孕期及哺乳期的安全性尚未确定；泰索帝应用于儿童的有效性及安全性尚未确定。 顺铂注射液说明书 【功效主治】 顺铂注射液为治疗多种实体瘤的一线用药与VP- INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/9a2653c07052f9c0757a866e901bf72c.png" \* MERGEFORMATINET 联合（EP方案）为治疗SCLC或NSCLC一线方案联合MMCIFO（IMP方案）或NVB等方案为目前治疗NSCLC常用方案以DDP为主的联合化疗亦为晚期卵巢癌骨肉瘤及神经母细胞瘤的主要治疗方案与ADMCTX等联用对多部位鳞状上皮癌移行细胞癌有效如头颈部宫颈食管及泌尿系肿瘤等“PVB”（DDPVLBBLM）可治疗大部分Ⅳ期非精原细胞睾丸癌缓解率 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b14c3f0e4b4e6048e6abfb4d5fa02771.png" \* MERGEFORMATINET %～ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b14c3f0e4b4e6048e6abfb4d5fa02771.png" \* MERGEFORMATINET %此外顺铂注射液为放疗增敏剂目前国外广泛用于Ⅳ期不能手术的NSCLC的局部放疗可提高疗效及改善生存期 【成份】 顺铂注射液主要成份顺铂D 【性状】 顺铂注射液为略带粘性的浅黄色澄明溶液 【用法用量】 顺铂注射液需用 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d37d83d1b6ad6d2a39c01a3b83151aee.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d37d83d1b6ad6d2a39c01a3b83151aee.png" \* MERGEFORMATINET ～ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET ml氯化钠注射液稀释滴注本药略带粘性为使剂量准确在吸出药液后再向瓶内注入适量氯化钠注射液稍作振摇荡涤粘附于瓶内壁的药液后吸出并加入至输液瓶中滴注 . 静脉滴注 一次按体表面积 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET mg/m INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/41afab5b814547dfab966fe8c8af87a6.png" \* MERGEFORMATINET 一日次连用日或 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d37d83d1b6ad6d2a39c01a3b83151aee.png" \* MERGEFORMATINET mg/m INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/41afab5b814547dfab966fe8c8af87a6.png" \* MERGEFORMATINET 一日次连用日间隔周再重复可重复～个疗程亦可 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/4f04bd4c0524b1de14cb20112b7bd678.png" \* MERGEFORMATINET ～ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET mg/m INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/41afab5b814547dfab966fe8c8af87a6.png" \* MERGEFORMATINET 同时进行水化疗法和利尿每～周用药次 . 动脉灌注 介入化疗联合用药时每次 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/4f04bd4c0524b1de14cb20112b7bd678.png" \* MERGEFORMATINET ～ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET mg/m INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/41afab5b814547dfab966fe8c8af87a6.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/fd3698f22c7aaecf70bdd9964c79e85f.png" \* MERGEFORMATINET 周次需给予水化利尿 . 胸腹腔注射 每次 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET ～ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET mg INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/34fba4325476fbdc0560574256904694.png" \* MERGEFORMATINET ～ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/4f04bd4c0524b1de14cb20112b7bd678.png" \* MERGEFORMATINET 天为一次 【禁忌】 肾损害患者及孕妇禁用 【不良反应】 . 消化道反应严重的恶心呕吐为主要的限制性毒性急性呕吐一般发生于给药后～小时可持续一周左右故用顺铂注射液时需并用强效止吐剂如-羟色胺（-HT）受体拮抗止吐剂恩丹西酮等基本可控制急性呕吐 . 肾毒性累积性及剂量相关性肾功不良是顺铂的主要限制性毒性一般剂量每日超过 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b14c3f0e4b4e6048e6abfb4d5fa02771.png" \* MERGEFORMATINET mg/m即为肾毒性的危险因素主要为肾小管损伤急性损害一般见于用药后 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d37d83d1b6ad6d2a39c01a3b83151aee.png" \* MERGEFORMATINET ～ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/3353c57902ba5cdb3c376d6f425102e6.png" \* MERGEFORMATINET 天血尿素氮（BUN）及肌酐（Cr）增高肌酐清除率降低多为可逆性反复高剂量治疗可致持久性轻至中度肾损害目前除水化外尚无有效预防顺铂注射液所致的肾毒性的手段 . 神经毒性神经损害如听神经损害所致耳鸣听力下降较常见末梢神经毒性与累积剂量增加有关表现为不同程度的手脚套样感觉减弱或丧失有时出现肢端麻痹躯干肌力下降等一般难以恢复癫痫及视神经乳头水肿或球后视神经炎则较少见 . 骨髓抑制骨髓抑制（白细胞和/或血小板下降）一般较轻发生几率与每疗程剂量有关若≤ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/4f04bd4c0524b1de14cb20112b7bd678.png" \* MERGEFORMATINET mg/m INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/6a4795778d10fb1d7a3a0c3e5d2dde2f.png" \* MERGEFORMATINET 发生机率约 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET ～ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET %若剂量≥ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/2a501bb9d923f7800410f861a539684d.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/4f04bd4c0524b1de14cb20112b7bd678.png" \* MERGEFORMATINET mg/m INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/6a4795778d10fb1d7a3a0c3e5d2dde2f.png" \* MERGEFORMATINET 则约 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b14c3f0e4b4e6048e6abfb4d5fa02771.png" \* MERGEFORMATINET %但亦与联合化疗中其它抗癌药骨髓毒性的重叠有关 . 过敏反应可出现脸肿气喘心动过速低血压非特异斑丘疹类皮疹 . 其它心脏功能异常肝功能改变少见 【注意事项】 监测末梢血象肝肾功能末梢神经毒及听力表现等变化必要时减少剂量或停药并进行相应的治疗避免采用与顺铂注射液肾毒性或耳毒性叠加的药物如氨基糖苷类抗生素两性霉素B头孢噻吩呋喃苯胺酸利尿酸钠等静滴时需避光 【孕妇及哺乳期用药】 孕妇禁用哺乳期妇女慎用 【老年用药】 老年患者肾小球滤过率及肾血浆流量减少药物排泄率减低故慎用如肾功正常可给予全量的 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET %～ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET % 【药物相互作用】 氨基糖甙类抗生素两性霉素B等与顺铂注射液并用有肾毒性叠加作用MTX及BLM主要由肾脏排泄顺铂注射液所致的肾损害会延缓上述两种药物的排泄导致毒性增加丙磺舒与顺铂注射液并用时可致高尿酸血症氯霉素或其呋喃苯胺酸或利尿酸钠增加顺铂注射液耳毒性抗组胺药可掩盖顺铂注射液所致的耳鸣眩晕等症状 【包装规格】 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET mg INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/e96c29784e4c44f48cb3dca82b56815d.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET mg 伯尔定(卡铂注射液)说明书 【功能主治】 伯尔定适用于治疗上皮来源晚期卵巢癌 . 第一线治疗 . 其他治疗失败后的第二线治疗 伯尔定还适用于治疗小细胞肺癌和头颈部鳞癌 【主要成份】 伯尔定主要成分及其化学名称为顺-二氨- INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/6a4795778d10fb1d7a3a0c3e5d2dde2f.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/7fad180800c9db942509817499a0f6b1.png" \* MERGEFORMATINET -环丁烷二羧酸合铂 【包装规格】 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/3353c57902ba5cdb3c376d6f425102e6.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET mg/ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b44922b09ca1cd8767e6392a3a7de21f.png" \* MERGEFORMATINET ml/支 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/1be6de81e2db9fc8f6a836e7be23e809.png" \* MERGEFORMATINET 支/盒 【用法用量】 本药仅供静脉使用肾功能正常的成人初治患者推荐剂量为 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET mg/㎡单剂静脉输注 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/8b1c6f0afd18a909c23e8db1ed47e547.png" \* MERGEFORMATINET - INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b14c3f0e4b4e6048e6abfb4d5fa02771.png" \* MERGEFORMATINET 分钟两次用药间隔周和/或中性粒细胞计数≥ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d37d83d1b6ad6d2a39c01a3b83151aee.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/4f04bd4c0524b1de14cb20112b7bd678.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b14c3f0e4b4e6048e6abfb4d5fa02771.png" \* MERGEFORMATINET /mm INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/df25cd0e6bad642bcca66bf482638179.png" \* MERGEFORMATINET 血小板计数≥ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/4f04bd4c0524b1de14cb20112b7bd678.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d37d83d1b6ad6d2a39c01a3b83151aee.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/4f04bd4c0524b1de14cb20112b7bd678.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET /mm方可进行下一疗程治疗 存在危险因素的病人 如以往有过骨髓抑制治疗史一般状况差(ECOG－Zubrod－ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d380aa06547e2c040e3e05c745b7e22d.png" \* MERGEFORMATINET 卡氏计分< INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d37d83d1b6ad6d2a39c01a3b83151aee.png" \* MERGEFORMATINET )的患者建议减少本药初治剂量的 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET ~ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/8b1c6f0afd18a909c23e8db1ed47e547.png" \* MERGEFORMATINET %对 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/3353c57902ba5cdb3c376d6f425102e6.png" \* MERGEFORMATINET 岁以上的病人应根据病人的体质情况调整初剂量及其后的剂量 建议在初始疗程中每周测定外周血细胞计数判断血细胞减少的最低点以便调整下一疗程的剂量 肾功能损害患者 肌酐清除率< INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/4f04bd4c0524b1de14cb20112b7bd678.png" \* MERGEFORMATINET ml/min患者发生严重骨髓抑制的危险性增加使用下述伯尔定推荐剂量时严重的白细胞减少中性粒细胞减少或血小板减 少发生率一般在 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/254349e857c998e91c5813d96aa79782.png" \* MERGEFORMATINET ％左右 . 肌酐清除率基线值 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/1be6de81e2db9fc8f6a836e7be23e809.png" \* MERGEFORMATINET － INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d7411b7a1f094e4e2b4e907b5842302b.png" \* MERGEFORMATINET ml/min初始剂量(第天) INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/254349e857c998e91c5813d96aa79782.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d37d83d1b6ad6d2a39c01a3b83151aee.png" \* MERGEFORMATINET mg/m IV. . 肌酐清除率基线值 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/6ce718789380c1b8304614ed1a8b89a5.png" \* MERGEFORMATINET － INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET ml/min初始剂量(第天) INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/4f04bd4c0524b1de14cb20112b7bd678.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET mg/m IV. 肌酐清除率< INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/758ad540b11deb0a59f99933571f90c9.png" \* MERGEFORMATINET ml/min的患者尚无足够的资料允许使用推荐剂量 上述推荐剂量均用于初始疗程以后的剂量应根据病人的耐受性骨髓抑制可接受程度加以调整 联合治疗 伯尔定与其他骨髓抑制剂联合使用时应根据治疗方案和调整剂量 公式计算法计算伯尔定剂量 计算伯尔定初始剂量另一种方法是根据患者伯尔定治疗前肾功能的状况得到的数学公式法与常规的体表面积计算相比公式法最大限度了因肾功能差异引起的变化避免了剂量不足（病人的肾功能高于正常）或过量（肾功能低于正常） 以下是Calvert提出的公式是根据病人的肾小球滤过率（GFRml/min）和设定的伯尔定的AUC（mg/ml min）计算伯尔定的剂量在Calvert的研究中GFR是以 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d70689258e66182eb5906c05b3266944.png" \* MERGEFORMATINET Cr-EDTA方法测定 Calvert 计算伯尔定剂量公式 总剂量(mg)=设定AUC×（GFR＋ INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/254349e857c998e91c5813d96aa79782.png" \* MERGEFORMATINET ） 注意根据公式计算伯尔定的剂量是总剂量而不是每平方米的剂量 . 设定AUC INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/254349e857c998e91c5813d96aa79782.png" \* MERGEFORMATINET －mg/ml.min化疗方案伯尔定病人治疗情况初次化疗 . 设定AUC INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/fd3698f22c7aaecf70bdd9964c79e85f.png" \* MERGEFORMATINET －mg/ml.min化疗方案伯尔定病人治疗情况接受过化疗 . 设定AUC INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/e60d0ad8b1553aecb5a172558cefd054.png" \* MERGEFORMATINET －mg/ml.min化疗方案伯尔定联合其它化疗药物病人治疗情况初次化疗 疗程 根据医师处方 配制指导 本药可进一步用%葡萄糖或.%氯化钠稀释到浓度为.mg/ml的溶液 在稀释或给药时伯尔定不能接触含铝的针头或其他器械铝与伯尔定会产生沉淀反应和/或降低效价 【不良反应】 以下不良反应的发生率系根据 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/3151eab5257bdcd81f0eafaa2b8a387a.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/292c135847df00d8e5ea380ea7de420b.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/de5572f5dd440f8812a0b3d598a41853.png" \* MERGEFORMATINET 例不同预后因素的病例资料整理 血液系统毒性 骨髓抑制是本药的剂量限制性毒性治疗前血象正常的病人血小板减少(低于 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/d37d83d1b6ad6d2a39c01a3b83151aee.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/5cac62650dcd3d3f90b8807bd003652b.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET /mm)发生率 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/3353c57902ba5cdb3c376d6f425102e6.png" \* MERGEFORMATINET %中性粒细胞减少(低于 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/bc29d34deb65055136a782ce82ba0e07.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b14c3f0e4b4e6048e6abfb4d5fa02771.png" \* MERGEFORMATINET INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/b14c3f0e4b4e6048e6abfb4d5fa02771.png" \* MERGEFORMATINET /mm)发生率 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/7dbbb4b37cc50eb0017fc23a862199a1.png" \* MERGEFORMATINET %和白细胞减少(白细胞计数低于 INCLUDEPICTURE "http://www.xywy.com/zhuanjia/images/char1/4f04bd4c0524b1de14cb