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首页> 外文期刊>The Journal of pharmacy technology: jPT : official publication of the Association of Pharmacy Technicians >Subdural Hematoma Due to Probable Warfarin-Fluorouracil Interaction
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Subdural Hematoma Due to Probable Warfarin-Fluorouracil Interaction

机译：华法林-氟尿嘧啶相互作用可能导致硬膜下血肿

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Objective: To describe the occurrence of a subdural hematoma in a woman undergoing chemotherapy with cyclophosphamide, methotrexate, and fluorouracil combined with warfarin therapy.Case Summary: A 60-year-old white woman with atrial fibrillation underwent radical mastectomy for primary breast cancer with histologically positive axillary lymph nodes. Following surgery, the patient received adjuvant chemotherapy with a CMF 1-8 regimen consisting of cyclophosphamide 100 mg/m2 orally on days 1-14, methotrexate 40 mg/m~2 intravenously, and fluorouracil 600 mg/m2 by intravenous bolus on days 1 and 8 every 4 weeks. Warfarin 5mg/day was administered concomitantly due to atrial fibrillation. Following the second course of concomitant therapy, the patient developed a headache, hemiparesis, and an international normalized ratio (INR) of 7.6, which was highly suggestive of a drug interaction between fluorouracil and warfarin. A computed tomography scan of the brain revealed a left parieto-occipital subdural hematoma.Discussion: This case emphasizes the importance of the potentially fatal drug interaction involving warfarin and fluorouracil.Conclusions: Several adverse interactions between warfarin and fluorouracil have been reported. Considering the severity of this interaction, close monitoring of the INR is recommended in patients receiving these agents concomitantly.
机译：目的：描述一名接受环磷酰胺，甲氨蝶呤和氟尿嘧啶联合华法林治疗的化疗患者的硬膜下血肿的发生。病例摘要：一名60岁的房颤白人妇女接受了原发性乳腺癌的根治性乳腺切除术，并进行了组织学检查腋窝淋巴结阳性。手术后，患者接受了CMF 1-8方案的辅助化疗，该方案包括在第1-14天口服100 mg / m2环磷酰胺，在第1天静脉滴注甲氨蝶呤40 mg / m〜2和通过静脉推注氟尿嘧啶600 mg / m2。每4周8个。由于心房颤动，同时服用华法林5mg /天。伴随第二疗程治疗后，患者出现头痛，偏瘫和国际标准化比率（INR）为7.6，这强烈暗示了氟尿嘧啶和华法林之间存在药物相互作用。脑部X线计算机断层扫描显示左顶枕硬膜下血肿。讨论：本病例强调了涉及华法林和氟尿嘧啶的潜在致命药物相互作用的重要性。结论：华法林与氟尿嘧啶之间存在几种不良相互作用。考虑到这种相互作用的严重性，建议在同时接受这些药物的患者中密切监测INR。

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