急性肾功能不全伴糖尿病、高血压1例的药学监护

Case Report on the Pharmaceutical Care of a Patient with Acute Renal Insufficiency,Diabetes Mellitus and Hypertension

目的：探讨临床药师在肾内科治疗方案的制订与用药监护中的工作要点。方法：参与1例急性肾功能不全伴糖尿病、高血压的药学监护和治疗用药方案的制订。结果：通过对症治疗和对因治疗后，患者病情好转：确定符合患者特点的抗感染方案．避免不良反应发生的策略，达到了理想的预后情况结论：个体化用药方案的设计与分析及用药监护是临床药师开展“以患者为中心“药学服务工作的切入点。

Object： To investigate the key point in determining the pharmacotherapy and pnarmaceuucal care oi renal disease patients. Method： Participating in the pharmaceutical care of a patient with acute renal insufficiency, diabetes mellitus and hypertension. Result： With supportive treatment and symptomatic treatment, the patient＇s condition improved. The pharmacist helped the clinician make an individualized treatment plan which is safe, rational and effective. Conclusion： Formulation and analysis of individualized treatment plan, as well as relative pharmaceutical care, are the starting points of the＇ patient oriented＇ clinical pharmacy.