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目的:探讨临床药师针对老年心肺疾病合并慢性肾功能不全患者的药学监护方法。方法:临床药师对1例老年心肺疾病合并慢性肾功能不全患者的抗菌药物、强心苷类、中药注射剂治疗进行药学监护。结果与结论:临床药师通过实践典型病例的药学监护,协同医师制订个体化给药方案,确保治疗药物的安全性和有效性;强调必须根据药敏试验选择抗菌药物,根据肌酐清除率调整抗菌药物剂量。
Objective: To investigate the clinical pharmacists for elderly cardiopulmonary disease with chronic renal insufficiency in patients with drug monitoring methods. Methods: The clinical pharmacist carried out the pharmacy care on the antibiotics, cardiac glycosides and Chinese medicine injections in one elderly patient with cardio-pulmonary disease and chronic renal insufficiency. RESULTS AND CONCLUSION: The clinical pharmacists collaborated with physicians to formulate individualized dosing regimens by practicing the medical supervision of typical cases to ensure the safety and effectiveness of the therapeutic drugs. It was emphasized that antibiotics should be selected according to the drug sensitivity test and the antibacterial drugs should be adjusted according to the creatinine clearance rate dose.