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Original article
Mandatory dexamethasone strictly monitored by pharmacists reduces the severity of pemetrexed-induced skin rash
  1. Naoko Usui1,
  2. Yoko Kondo1,
  3. Noriko Ryota2,
  4. Hidekazu Suzuki3,
  5. Norio Okamoto3,
  6. Masumi Sando1,
  7. Eriko Tani3,
  8. Masanari Hamaguchi3,
  9. Ayako Tanaka3,
  10. Motohiro Tamiya3,
  11. Takayuki Shiroyama3,
  12. Naoko Morishita3,
  13. Emiko Tanaka1,
  14. Tomonori Hirashima3
  1. 1 Department of Pharmacy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Osaka, Japan
  2. 2 Department of Nursing, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Osaka, Japan
  3. 3 Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Osaka, Japan
  1. Correspondence to Tomonori Hirashima, Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1 Habikino, Habikino City, Osaka 583-8588, Japan; hirashimat{at}ra.opho.jp

Abstract

Objective The present study aimed to retrospectively examine the effectiveness of mandatory dexamethasone (m-DEX) strictly monitored by pharmacists collaborating with medical physicians and nurses for reducing pemetrexed (PEM)-induced skin rash in patients with non-squamous non-small-cell lung cancer (ns-NSCLC).

Methods We compared the rash grades during the first cycle of PEM-containing regimens between patients who received m-DEX after February 2012 and those who received dexamethasone (DEX) at their physician's discretion (d-DEX) before January 2012.

Results Of 163 patients with ns-NSCLC included in this study, 89 received d-DEX and 74 received m-DEX. The mean DEX doses the night before and the day after PEM administration were significantly higher in the m-DEX group than in the d-DEX group. The frequency of grade ≥2 skin rash was significantly lower in the m-DEX group than in the d-DEX group.

Conclusions The use of m-DEX strictly monitored by pharmacists might significantly reduce the severity of PEM-induced skin rash.

  • collaborative drug therapy management
  • pemetrexed
  • skin rash
  • dexamethasone
  • non-squamous non-small-cell lung cancer

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/ejhpharm-2016-000957

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