【摘要】 目的 探讨慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）治疗方案及药学监护的内容。 方法 以2007年12月收治的1例COPD患者为例，结合COPD治疗指南，为COPD急性加重期患者制定个体化的药学监护计划并实施全程的药学监护。 结果 患者COPD急性加重期的药物治疗方案有效合理。通过全程的药学监护，及时发现和解决了患者药物治疗的问题，为临床合理用药提供了意见。 结论 对COPD患者实施药学监护具有可行性和实用性。【Abstract】 Objective To investigate the treatment and pharmaceutical care for chronic obstructive pulmonary disease (COPD) patients. Methods In December 2007, a patient with COPD was diagnosed, and based on the clinical data, COPD treatment guidelines were adopted to analyze treatment plans. For patients with acute exacerbation of COPD, individualized pharmaceutical care plan was proposed, and pharmaceutical care was performed during the whole course of disease. Results The drug treatment for the one patient with acute exacerbation of COPD was effective and reasonable. Treatment problems were observed and solved through pharmaceutical care which had given reasonable suggestions for medication. Conclusion The implementation of pharmaceutical care for COPD patients is feasible and practical.
目的 探讨临床药师在支气管哮喘住院患者的药学监护作用。 方法 临床药师在呼吸科参与具体药物治疗的1例支气管哮喘住院患者药学监护过程进行分析总结。 结果 临床药师通过全程的药学监护，及时发现并解决相关药物治疗问题，为临床提供合理建议，加强了患者用药的安全性。 结论 临床药师实施药学监护对患者个体化治疗具有极其重要的意义。
目的 报道临床药师参与抗结核药物致结核性胸膜炎待诊患者多形红斑型药疹的临床药学实践的经验。 方法 1例结核性胸膜炎待诊患者在2011年11月3日出现皮疹后，临床药师根据患者的用药情况及病情变化，提供咨询意见，与临床医师共同制定不良反应的临床处理措施。 结果 推断为链霉素所致的多形红斑型药疹，积极处理后患者病情好转。 结论 临床药师参与药学监护，有利于处理药物不良反应。
【摘要】 目的 验证临床药师对外科预防使用抗菌药物进行干预的效果。 方法 以临床药师督查记录数据为基础，将2010年1-3月238份病历设为非干预组，2010年10—12月240份病历设为干预组，建立评价标准，进行回顾性汇总、分析。 结果 通过干预，抗菌药物使用率从干预前的100%下降为77.08%（χ2=63.633，P=0.000），抗菌药物联用情况减少（χ2=53.712，P=0.000），用药时机和用药疗程有了较大改善，抗菌药物费用下降（t=-5.235，P=0.000），住院医疗费用降低（t’=-12.280，P=0.000），住院天数减少（t=-5.071，P=0.000）。 结论 临床药师通过实施合理用药干预对促进医院安全、有效、经济使用抗菌药物起到了积极作用。【Abstract】 Objective To verify the effect of clinical pharmacists’ intervention in antibiotics used for Type I incision surgical prevention. Methods Based on the supervision and inspection recording data of clinical pharmacists, we arranged 238 medical records in the first quarter of 2010 as non-intervened group and 240 medical records in the fourth quarter of 2010 as intervened group, and then established evaluation criteria and conducted a retrospective study for analysis. Results Through intervention, the rate of using antibiotics decreased from the previous 100% to 77.08% (χ2=63.633, P=0.000), the use of combined antibiotics also decreased (χ2=53.712, P=0.000), the time of course of using antibiotics improved, medical expenses of the antibiotics were reduced (t=-5.235, P=0.000), hospitalization cost decreased (t=-12.280, P=0.000), and hospital stay was shortened (t=-5.071, P=0.000). Conclusion Clinical pharmacists’ intervention in rational use of drugs play a positive role in contribution to a safe, effective and economical application of antibiotics.
【摘要】 目的 验证临床药师对我院中药注射剂合理使用进行干预的效果。 方法 对比分析2010年临床药师干预前后中药注射剂的合理使用情况，随机抽取2010年1-6月合格病历1 000份，设为非干预组；随机抽取2010年9月-2011年2月合格病历1 000份，设为干预组；评估临床药师的干预作用。 结果 非干预组中药注射剂的使用率为31.10%，干预组为19.00%，差异有统计学意义（χ2=38.991，P=0.000）；非干预组适应证不合理的为6.00%，干预组为2.10%，差异有统计学意义（χ2=19.570，P=0.000）；非干预组发生不良反应15例，干预组发生3例，两组不良反应发生率差异有统计学意义（χ2=8.073，P=0.004）；中药注射剂的用法用量趋于规范。 结论 临床药师对中药注射剂临床使用的干预行之有效，对促进医院安全、有效、合理使用中药注射剂起到了积极作用。【Abstract】 Objective To explore the effects of clinical pharmacists intervention on traditional chinese medicine injection. Methods Compared the rational usage of traditional Chinese medicine injection in 2010 after the intervention of clinical pharmacists. A total of 1 000 clinical case records from January to June 2010 were randomly selected and was named as the non-intervention group; another 1 000 clinical case records from September 2010 to February 2011 were randomly selected and was named as the intervention group. The effect of the clinical pharmacists were evaluated. Results The utilization rate of the Chinese medicine injection was 31.10% in non-intervention group and 19.00% in the intervention group with a significant difference between the two groups (χ2=38.991，P=0.000). The irrationality of indication was 6.00% in non-intervention group and 2.10 in the intervention group with a significant difference between the two groups （χ2=19.570，P=0.000）. The adverse reaction was found in 15 patients in non-intervention group and in three patients in the intervention group with a significant difference between the two groups（χ2=8.073，P=0.004）. The usage and dosage of Chinese traditional medicine injection was tend to be normative. Conclusion The intervention on traditional Chinese medicine injection by clinical pharmacists is effective, which is a important part in promoting the rational use of traditional Chinese medicine injection.
ObjectiveTo explore the role of clinical pharmacists in caring for one patient with breast cancer complicated with multiple metastases. MethodsClinical pharmacists monitored the entire treatment process of a patient with breast cancer complicated with multiple metastases. Blood glucose level was recorded, and the pharmacists evaluated the patient's pain, gave appropriate doses of cancer pain drugs, and responded positively to the hand-foot syndrome (HFS) induced by chemotherapeutic drugs. ResultsWith the participation of the pharmacists, clinicians adjusted the medication. Ideal control of cancer pain and blood glucose was achieved with successful chemotherapy, and HFS fully recovered. ConclusionPharmaceutical care by clinical pharmacists can assist clinicians to ensure the safety and effectiveness of drug use.
ObjectiveTo discuss the practical methods of clinical drug therapy with clinical pharmacists' participation. MethodThe patient was male and at the age of 88. Because of "exertional heart tiredness for 4 years, coughing sputum for 10 days, and sudden inarticulate condition", he was admitted into the hospital on November 22nd, 2013. The diagnosis was cerebral infarction with pulmonary infection. Clinical pharmacists participated in the consultation on February 19th, 2014 because the uncontrollable repeated pulmonary infection. By analyzing the therapeutic scheme, clinical pharmacists made and adjusted the treatment scheme for one patient with refractory infections. ResultsAfter the treatment scheme was adjusted, several laboratory test results of the patient returned to normal, including respiratory rate, body temperature, white blood cell count and neutrophils. Sputum volume decreased obviously and sputum culture was negative. Lung signs and image were significantly improved. ConclusionsClinical pharmacists should pay more attention to the analysis of the clinical therapeutic scheme to improve therapeutic efficacy for patients with refractory infections.
Objective To investigate the role of clinical pharmacists in warfarin therapy. Methods A total of 134 patients underwent prosthetic heart valve replacement and had warfarin for life from March 2013 to October 2013 in Fujian Medical University Union Hospital. All patients were equally divided into two groups (an intervention and a non-intervention group) crosswise by sequence. There were 67 patients in each group. The anticoagulant effects of the two groups were compared. Results There was no statistical difference in the patients' demographic information between the two groups. However, the time for the patients to reach the target international normalized ratio(INR) values for the first time (7.1±3.3 dvs. 10.5±5.0 d,P=0.000) and time of INR in the therapy range (46.3%±18.8%vs.19.0%±16.2%,P=0.000) during their hospitalization, proportion of time of under anticoagulation (47.5%±19.5%vs. 71.2%±22.9%,P=0.000), proportion of time of anticoagulation overdose (5.3%±8.2%vs. 9.9%±16.7%,P=0.002) were significantly different. While there was no statistical difference in postoperative hospitalization time between the two groups (19.9±6.6 dvs. 18.1±7.0 d,P=0.137). There were 4 patients (6.0%) with minor hemorrhage and no severe complication was found in the intervention group. There were seven patients (10.4%) with mild hemorrhage, two patients with stroke, one patient with mild pulmonary embolism, and severe complication rate of 4.5% in the non-intervention group. Conclusion With clinical pharmacists involved in the whole anticoagulation therapy progress of patients after mechanical heart valve replacement, the time to achieve the therapeutic window for the first time is effectively shorten, and the time of the INR value controlled in therapeutic range is highly improved during hospitalization time. Moreover, the patients' risk of thrombosis and bleeding is eventually reduced.