1例老年患者支气管扩张合并感染伴心衰的药学监护医学.docxVIP

1例老年患者支气管扩张合并感染伴心衰的药学监护刘冰冰1,2（1中国医科大学附属盛京医院，药学部，2阜新矿业集团总医院，药剂科，）刘晓东（1中国医科大学附属盛京医院，药学部，）【摘要】目的 探讨临床药师参与临床治疗中，如何最大限度地发挥药物的临床疗效及尽早发现药物不良反应，促进临床合理用药。方法 临床药师全程参与一例支气管扩张合并感染伴心功能不全患者的临床治疗过程，对临床给药方案进行分析和概述，监测患者病情及易因药物产生异常的检查指标，预防并及时处理药物相关不良反应。结果 抗感染治疗中，根据患者病情先后给予美罗培南，左氧氟沙星，依替米星和头孢曲松他唑巴坦治疗。同时监测患者的肝肾功能，及时发现患者出现的转氨酶异常，并给予保肝治疗。警惕依替米星可能出现的不良反应。协助临床医生合理制定治疗心衰药物的选用与剂量调整。并对患者进行健康教育。结论 临床药师参与治疗时及时发现问题，寻找临床药学监护点，为患者提供个体化治疗方案，提高用药合理与用药安全，体现临床药师在参与药物治疗中的积极作用。【关键字】临床药师 药学监护 支气管扩张合并感染 心功能不全 Pharmaceutical care of the case of elderly patients with bronchiectasis with infection with heart failureLiu Bingbing 1,2 (1 China Medical University Shengjing Hospital, Department of Pharmacy, 2 General Hospital of Fuxin Mining Group, Department of Pharmacy, ) Liu Xiaodong (China Medical University Shengjing Hospital, Department of Pharmacy, )[Abstract] Objective To investigate the clinical pharmacist participation in clinical treatment, how to maximize the clinical efficacy of the drug and the early detection of adverse drug reactions, promote clinical rational drug use. Methods clinical pharmacists involved throughout one case of bronchiectasis with infection with cardiac dysfunction patients clinical course of treatment, analysis and overview of the clinical dosing regimen, monitoring the patients condition and abnormal check indicators vulnerable to drug prevention and timely treatment of drug-related adverse reaction. Results In anti-infection treatment, according to the patients condition has given meropenem, levofloxacin, depending on the behalf of meters Stars and ceftriaxone tazobactam treatment. While monitoring the patients liver and kidney function, to detect patients with transaminase abnormalities, and give the liver treatment. The vigilance adverse reactions may occur etimicin. Assist clinicians in establishing reasonable treatment of heart failure drug selection and dosage adjustment. And patients with health education. Conclusions Clinical pharmacists involved in the treatment of the