临床药师参与伏立康唑治疗方案调整1例并文献复习  

Clinical Pharmacists Participating in the Adjustment of Treatment Regimen of Voriconazole: A Case Report and Literature Review

作　　者：庞露[1] 朱珂[2] 孙亚欣[1] 李国飞[1] 刘立民[1] 朱旭[1] 肇丽梅[1] PANG Lu;ZHU Ke;SUN Yaxin;LI Guofei;LIU Limin;ZHU Xu;ZHAOLimei(Shengiing Hospital of China Medical University,Department of Pharmacy,Shenyang 110004,China;Shengiing Hospital of China Medical University,Department of Hematology,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院药学部,沈阳110004 [2]中国医科大学附属盛京医院血液科,沈阳110004

出　　处：《中国现代应用药学》2018年第11期1725-1728,共4页Chinese Journal of Modern Applied Pharmacy

摘　　要：目的探讨临床药师参与1例使用伏立康唑治疗肺部真菌感染患者的治疗方案调整,为复杂患者的个体化用药提供信息支持。方法临床药师利用治疗药物监测及基因检测作为技术支持,药学指南及文献作为信息支持,为临床医师提供参考意见,改善治疗效果。结果治疗过程中,临床药师根据患者情况提出用药调整建议,与医师共同制定个体化治疗方案并随时调整,节省了医疗费用,提高了患者的依从性。结论临床工作中,部分患者存在治疗疗程长、联合用药复杂的问题,治疗药物监测、基因检测等技术的应用,为临床个体化用药提供了技术保障,而临床药学人员的参与,也为个体化用药的逐步完善提供了一定的支持。OBJECTIVE To adjust the treatment regimen,the clinical pharmacist involved in the treatment of one patient with pulmonary fungal infection treated with voriconazole,who provide information support for the individualized medication of complicated patients.METHODS Clinical pharmacist used therapeutic drug monitoring and genetic testing as technical support,pharmacy guidelines and literature as information support to provide suggestion for clinicians and improve the therapeutic effect.RESULTS During the course of treatment,the clinical pharmacist recommended adjustments for medication according to the patient's condition,and formulated individualized treatment plans with clinicians to save medical expenses and improve patient compliance.CONCLUSION Some patients have long treatment course and complex combination of drugs in clinical practice.Therapeutic drug monitoring,genetic testing and other technologies can provide technical support for individualized medication.And the participation of clinical pharmacist also can provide some support for individualized medication.

关 键 词：伏立康唑 药物监测 基因检测 个体化用药 临床药师 

分 类 号：R969.4[医药卫生—药理学]