临床药师参与肾移植术后合并急性心肌梗死患者的药学监护

Clinical pharmacists participate in the pharmaceutical care of patients with acute myocardial infarction after renal transplantation

目的 :探讨临床药师对特殊生理或病理状态患者的药学监护方法,为临床合理用药提供参考。方法 :对1例肾移植术后4年发生急性非ST段抬高型心肌梗死患者从药物选择、相互作用、代谢、排泄等方面进行全程的药学监护,为医师的药物治疗提供合理化用药建议。结果 :通过药师积极参与下的药学监护,患者好转出院。结论 :临床药师参与临床药物治疗过程,为患者制定个体化的药物治疗和监护方案,可以有效保障患者用药安全,提高个体化用药水平。

Objective： To explore the clinical pharmaceutical care methods for patients with special physiological or pathological conditions so as to provide reference for clinical rational use of drugs. Methods： The clinical pharmacist offered the entire pharmaceutical care including drug selection, interaction, metabolism, excretion to the patients who suffered from acute non-s-segment elevation myocardial infarction with 4 years kidney transplantation and provided recommendations of the rational drug use for the physician medication. Results： The patient safely discharged from hospital by pharmaceutical care under the active participation of the pharmacists. Conclusion： The safety of patients＇ medication can be effectively guaranteed and the level of individualized medication can be improved by clinical pharmacists participating in clinical drug treatment processes and developing individualized medication and pharmaceutical care for patients.