1例伴肝功异常的胰腺癌患者癌症疼痛的药学监护

Pharmaceutical Care for Pain in a Pancreatic Cancer Patient Accompanied with Abnormal Liver Function

目的:本文拟探讨临床药师在老年肿瘤患者疼痛控制中的作用。方法:对1例伴肝功异常的老年胰腺癌姑息治疗患者,从疼痛评估、疼痛药物的选择及调整、不良反应监测与处理、患者用药教育等方面提供药学服务及全程药学监护。结果:临床药师全面评估患者的疼痛情况,考虑患者合并炎症疼痛及神经病理性疼痛,建议使用羟考酮缓释片联合加巴喷丁控制疼痛,并根据疼痛情况进行药物剂量调整。患者用药后出现恶心呕吐,结合慢性胃炎病史,建议使用质子泵抑制剂奥美拉唑口服,对便秘、腹泻采用麻仁润肠丸联合甘油灌肠,肝功异常合并高血压建议肝功恢复后停用异甘草酸镁,并给予硝苯地平控释片。同时,临床药师为患者及家属提供用药教育,提高治疗依从性。患者疼痛减轻,并发症得以控制。结论:临床药师参与癌痛治疗,可以优化治疗方案,减少并发症,提高治疗依从性,保证用药安全、有效。

Objective:This article aims to explore the role of clinical pharmacist in cancer pain treatment.Methods:Clinical pharmacist served a pancreatic cancer patient.The pharmacist offered pharmaceutical care in pain assessment,drug usage,prevention and treatment of adverse drug reaction,and provided patient pharmacy education And full pharmaceutical car.Results:Pain in patients with clinical pharmacists comprehensive assessment,consider a patient with inflammatory pain and mental derangement rational pain,recommend the use of oxycodone zyban joint gabapentin control pain,pain and according to the situation of nausea and vomiting after adjustment of patients medication dose of drug,combined with the history of chronic gastritis,recommend the use of proton pump inhibitors omeprazole oral,adopting maren runchang pill to treat constipation diarrhea joint glycerine enema,liver meritorious service is restored after hypertension suggest liver meritorious service is discontinued glycyrrhizic acid magnesium,and to give nifedipine retard-20 tablet at the same time,the clinical pharmacists to provide medication education for patients and their families,to improve treatment complianceThe patient's pain is reduced and complications are controlled.Conclusions:The participation of clinical pharmacists in the treatment of cancer pain can optimize the treatment plan,reduce complications,improve treatment compliance,and ensure the safety and effectiveness of medication.