Pharmaceutical care of a patient with severe hand-foot skin reactions induced by apatinib mesylate and literature review

Abstract

Objective： To explore pharmaceutical care methods for hand-foot skin reactions induced by apatinib mesylate tablets，so as to provide reference for rational use of drugs clinically.Methods： A case of severe hand-foot skin reactions induced by apatinib mesylate tablets in the treatment of advanced gastric cancer was reported.The clinical manifestations，treatment principles and possible mechanism of the disease were reviewed in combination with literature.Results： Most of the hand-foot skin reactions caused by oral administration of apatinib mesylate tablets occurred 2-3 weeks after medication，mostly with clinical manifestations of erythema in palms，fingers，joints and toes accompanied with swelling and pain，as well as hyperkeratosis of the skin with paresthesia.The occurrence of hand-foot skin reactions caused by apatinib mesylate tablets were associated with such factors as inhibition of vascular endothelial growth factor and decreased capillary repair capacity and other factors.To prevent its occurrence，daily life care，adjustment of the dosage of apatinib mesylate，external application of topical emollients containing urea，analgesics and external use of super-potent topical corticosteroids could obviously reduce the severity of hand-foot skin reactions.If hand-foot skin reactions were recurrent and difficult to control，replacement with other targeted drugs could be considered.Conclusion： In the application of apatinib mesylate tablets，hand-foot skin reactions were not rare.Close attention should be paid to drug monitoring on the part of clinicians and clinical pharmacists，so that the occurrence of adverse drug reactions could be reduced.In case there were hand-foot skin reactions，timely symptomatic treatment and close observation should be given，so as to improve the safety and efficacy of drug therapy.