一例新型冠状病毒肺炎合并多种慢性基础疾病患者的药学监护

Pharmaceutical care for a COVID-19 patient with various chronic underlying diseases

目的探讨临床药师对新型冠状病毒肺炎(COVID-19)合并高血压、糖尿病以及慢性肾衰竭患者的用药监护。方法我院为湖北省武汉市COVID-19定点救治医院,疫情期间,临床药师运用PASS系统对患者的用药情况进行监控,包括品种遴选、用法用量、药品不良反应(ADR)以及相互作用等。对用药合理性进行审核,利用系统预警、电话和微信等途径与一线医护人员和患者进行实时沟通,为患者提供个体化用药监护。结果医生及时采纳了临床药师对于激素使用指征、降糖药物选择、抗菌药物更换、ADR处置等意见。治疗后,患者呼吸道症状明显好转、CT病灶明显吸收、新型冠状病毒核酸检测连续2次阴性。血压、血糖与血脂水平控制情况良好。结论COVID-19的治疗方案更新快,涉及药物品种多,该患者合并多种慢性基础疾病,给治疗带来一定的难度。临床药师应对患者进行用药监护,保障患者用药有效与安全。

Objective To investigate the medication monitoring of COVID-19 in patients with hypertension,diabetes and chronic kidney failure.Methods Our hospital is a designated hospital of COVID-19 in Wuhan,Hubei Province.During the epidemic period,clinical pharmacists used PASS system to monitor the medication of patients,including the selection of varieties,dosage,adverse drug reactions(ADR),and interactions.Clinical pharmacists reviewed the rationality of medication,communicated with frontline medical staff and patients in real time by using system warning,telephone and WeChat,and provided personalized medication monitoring for patients.Results The doctors promptly adopted the suggestions of clinical pharmacists on the indication of hormone use,selection of hypoglycemic drugs,replacement of antimicrobial drugs and the management of ADR.After treatment,the respiratory symptoms of patient was improved significantly,CT lesions were significantly absorbed,and the novel coronavirus nucleic acid test was negative for two consecutive times.Blood pressure,blood sugar and blood lipid levels were well controlled.Conclusion The treatment strategy of COVID-19 is updated quickly,involving a variety of drugs.The patient has multiple chronic underlying diseases,which makes the treatment difficult.Clinical pharmacists should monitor the medication of patients and ensure the effectiveness and safety in patient′s medication.