临床药师在消化科开展药学服务的实践与探索

发布时间：2018-04-04 04:53

  本文选题：临床药师　切入点：药学服务　出处：《中国药房》2015年17期

【摘要】：目的:探讨临床药师在消化科开展药学服务和参与临床实践的模式和方法。方法:根据消化科患者及所使用药物的特点,对标准化流程、抗菌药物管理、药品不良反应(ADR)监测、个体化用药监护、护理人员用药安全指导等方面进行回顾性总结。结果:1例男性肝脓肿患者,帕尼培南调整为1 g,bid,患者用药后4 d未出现体温反跳,逐渐趋于平稳,治疗后复查B超肝脓肿明显缩小。1例女性肝脓肿伴肾功能重度损害患者,调整亚胺培南/西司他丁钠0.25 g,tid,ivgtt抗感染治疗10 d,CT显示肝脓肿明显缩小,且血肌酐下降至128μmol/L,遂将亚胺培南/西司他丁钠改为0.5 g,tid,ivgtt,12 d后调整为头孢吡肟1 g,bid,ivgtt继续治疗。18 d后,患者好转出院。临床药师共填报消化科病区ADR 26例,其中与输液相关16例,占61.54%;与抗生素相关12例,占46.15%;严重ADR 10例,其中新的严重ADR 3例;8例为院外已发生药物性肝损伤。应结合消化科疾病种类繁多、联合用药普遍、药源性疾病发生率高等特点,找准切入点,为临床提供适宜的药学服务。
[Abstract]:Objective: to explore the mode and method for clinical pharmacists to carry out pharmaceutical care and participate in clinical practice in digestive department.Methods: according to the characteristics of the patients and the drugs used in digestive department, the standardization process, antimicrobial management, ADR monitoring, individualized drug monitoring and safety guidance of drug use by nursing staff were summarized retrospectively.Results in 1 male patient with liver abscess, Panipenem was adjusted to 1 g bidbid.There was no rebound of body temperature at 4 days after treatment, which tended to be stable. After treatment, 1 case of liver abscess with severe impairment of renal function was obviously reduced by B-ultrasound.璋冩暣浜氳兒鍩瑰崡/瑗垮徃浠栦竵閽，

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