论文部分内容阅读
目的:为临床药师参与临床药物治疗,实施药学监护,保障临床患者抗肿瘤药物的合理使用提供参考。方法:以1例胃癌伴肝转移患者突发血小板减少为例,临床药师介入,通过循证药学方法,结合临床具体情况,解决临床提出的问题,并提出具有针对性的治疗建议。结果:由文献检索和临床分析可推测,引发患者突发血小板减少的药物可能为奥沙利铂,其作用机制在于奥沙利铂依赖的抗原与血小板的抗体反应所致;文献检索结果表明此类突发而急剧的血小板减少均在多次接受奥沙利铂治疗后才出现,与本案临床情况相吻合;据此协助临床医师制订了升高患者血小板的治疗方案,使患者获得了明显疗效。结论:临床药师加入治疗团队,参与临床治疗实践,对患者进行治疗监护,可使临床用药更趋合理,减少药品不良反应对患者造成的伤害,提升患者用药依从性及治疗效果;且有利于提高临床药物治疗的总体水平。
Objective: To provide references for clinical pharmacists to participate in clinical drug therapy, implement pharmacy care and ensure the rational use of anticancer drugs in clinical patients. Methods: A case of sudden thrombocytopenia in a patient with gastric cancer and liver metastasis was taken as an example. The clinical pharmacist intervened. The clinical problems were solved by evidence-based pharmacy and the clinical situation. Some targeted treatment recommendations were also proposed. Results: According to the literature search and clinical analysis, it is speculated that the drug inducing sudden thrombocytopenia may be oxaliplatin, which is caused by the reaction of oxaliplatin-dependent antigen and platelet antibody. The literature search results show that this Emergent and rapid thrombocytopenia occurred after multiple oxaliplatin treatment, consistent with the clinical situation; in accordance with this to help clinicians to develop a treatment plan for patients with elevated platelets, so that patients receive significant effect . Conclusion: The participation of clinical pharmacists in the treatment team, participation in clinical practice, patient care and treatment can make the clinical medication more reasonable, reduce adverse drug reactions to patients caused by injury, improve patient compliance and treatment of medication; and help to improve The overall level of clinical drug treatment.