临床药师参与1例重叠综合征合并延髓梗死患者个体化治疗的实践

Practice of Individualized Treatment for One Overlap Syndrome Patient with Medulla Oblongata Infarction by Clinical Pharmacist

以1例重叠综合征合并延髓梗死患者为例,探讨临床药师在患者个体化治疗中的作用。临床药师参与患者糖皮质激素、环磷酰胺、抗凝药物、延髓梗死后降压药物的药学监护,提高患者药物治疗效果、减少或延缓不良反应的发生。通过对治疗方案的优化,患者病情得到有效控制,糖皮质激素剂量滴定更合理,环磷酰胺使用后未出现尿路刺激症状、国际标准化比值(INR)维持在有效的治疗窗口内,延髓梗死后血压逐渐调整在目标范围之内,以上药物的不良反应得到密切监测。临床药师参与患者用药监护,可提高药物治疗的有效性和安全性,提高患者依从性,促进临床合理用药。

To explore the role of clinical pharmacist in the individualized treatment using a case of overlap syndrome patient with medulla oblongata infarction as the example.Clinical pharmacists participated in the pharmaceutical monitoring of patient treated with glucocorticoids,cyclophosphamide,anticoagulant drugs and antihypertensive drugs after medullary infarction to improve the effects of drug treatment and reduce or delay the occurrence of adverse reactions.Treated with the optimized regimen,the patient’s condition was effectively controlled,the glucocorticoid dose titration was more reasonable,there was no urinary tract irritation after using cyclophosphamide,the INR value was maintained within the effective treatment window,and the blood pressure was gradually adjusted within the target ranges after the bulbar infarction.Moreover,the adverse reactions of above drugs were closely monitored.Clinical pharmacists should participate in patient medication monitoring,which can improve the effectiveness and safety of drug treatment,improve patient compliance and promote clinically rational drug use.