临床药师参与肾移植术后合并肺孢子菌肺炎的药学监护

Pharmaceutical care of clinical pharmacist on patients with Pneumocystis carinii pneumonia after renal transplantation

目的:通过参与肾移植术后合并肺孢子菌肺炎患者的药物治疗实践,探讨临床药师参与药物治疗和开展药学监护的方法。方法:以1例肾移植术后合并肺孢子菌肺炎患者的诊治过程为例,根据肾移植术后患者肺部感染特点及治疗原则,从抗感染方案的制订、免疫抑制剂及激素的优化、患者用药教育等方面讨论肾移植术后肺孢子菌肺炎患者的药学监护特点。结果:临床药师通过认真分析患者的病情,提出了合理化建议,取得了很好的疗效。结论:临床药师发挥自身专业特长,找准切入点,可协助临床医师及时、有效地制订治疗方案,为患者提供专业的药学服务。

OBJECTIVE To explore the methods of individualized medications and pharmaceutical care for patients with Pneumocystis carinii pneumonia （PCP）aher renal transplantation when clinical pharmacists worked in clinical departments. METHODS According to the characteristics of PCP after renal transplantation and treatment principle,we discussed the phar- maceutical care points of patients with the PCP after renal transplantation in terms of the antiinfective agents varieties selection, immunosuppressants and cortical hormone optimization and the medicine education of patients. RESULTS Clinical pharmacists seriously analyzed patient＇s condition, put forward rational suggestions, and finally got satisfactory therapeutic efficacy. CON- CLUSION It is possible for clinical pharmacist to assist clinician to adjust the therapeutic regimen and provide professional pharmacy services for patients.