肿瘤药学2025，Vol.15Issue(1)：130-136,7.DOI:10.3969/j.issn.2095-1264.2025.01.18
奈妥匹坦帕洛诺司琼胶囊致5-羟色胺综合征病例分析
Analysis of serotonin syndrome caused by netupitant and palonosetron capsules
摘要
Abstract
To assist clinicians and pharmacists in understanding the mechanism and management of serotonin syn-drome induced by netupitant and palonosetron(NEPA)capsules,clinical pharmacists analyzed three cases of hormone re-ceptor-positive breast cancer patients undergoing ddEC-T chemotherapy who developed serotonin syndrome after using NEPA capsules.The analysis was conducted by reviewing the clinical characteristics,diagnosis,and treatment processes,combined with a literature review,to provide insights for safe clinical medication practices.All three patients were adminis-tered NEPA capsules one hour before chemotherapy as antiemetic prophylaxis and developed serotonin syndrome within 24 hours post-chemotherapy.Symptoms included autonomic hyperactivity(such as dizziness,fever,nausea,sweating,epigas-tric discomfort,palpitation,etc.),neuromuscular abnormalities(such as limb numbness,tremors in the right upper limb,uri-nary incontinence,etc.)and mental state changes(such as emotional anxiety,distress,etc.).The patient received symptom-atic treatment including bed rest,continuous oxygen therapy,cardiac monitoring,intravenous rehydration with potassium supplementation,antiemetics,and oral diazepam for sedation when necessary,and the symptoms were alleviated.Using the Naranjo adverse drug reaction probability scale,the association between serotonin syndrome and the suspected drug,NEPA capsules,was evaluated with a score of 7,indicating a probable relationship.Clinical pharmacists suggested that serotonin syndrome might be related to drug interactions between NEPA and chemotherapy agents such as cyclophosphamide or adju-vant drugs like cimetidine,or possibly due to increased dosage of NEPA.It was recommended to consider alternative NK-1 receptor antagonists(aprepitant)for subsequent treatments.Prevention is crucial in managing serotonin syndrome,and clini-cians should avoid potential drug-drug interactions.Alternative therapeutic agents should be considered based on the pa-tient's condition,and close monitoring is essential when combination therapy is unavoidable.关键词
激素受体阳性型乳腺癌/奈妥匹坦帕洛诺司琼胶囊/5-羟色胺综合征/不良反应/阿瑞匹坦Key words
Hormone receptor positive breast cancer/Netupitant and palonosetron capsules/Serotonin syndrome/Ad-verse drug reactions/Aprepitant分类
临床医学引用本文复制引用
周伶俐,郑志元,陈娜,符一岚..奈妥匹坦帕洛诺司琼胶囊致5-羟色胺综合征病例分析[J].肿瘤药学,2025,15(1):130-136,7.基金项目
湖南省儿童安全用药临床医疗技术示范基地基金资助项目(2023SK4083). （2023SK4083）
