临床药师参与肾移植患者管理的工作模式探讨及药学监护实践  

Discussion on the working mode of clinical pharmacist participating in the management of renal transplant patients and pharmaceutical care practice

作　　者：钱卿[1] 胡楠[1] 薛冬[2] 范敏[2] 陈荣[1] 邹素兰[1] 王莉英[1] QIAN Qing;HU Nan;XUE Dong;FAN Min;CHEN Rong;ZOU Su-lan;WANG Li-ying(Department of Pharmacy,The First People's Hospital of Changzhou,Jiangsu Changzhou 213003,China;Department of Urology,The First People's Hospital of Changzhou,Jiangsu Changzhou 213003,China)

机构地区：[1]常州市第一人民医院,药剂科,江苏常州213003 [2]常州市第一人民医院,泌尿外科,江苏常州213003

出　　处：《中国医院药学杂志》2020年第18期1987-1991,共5页Chinese Journal of Hospital Pharmacy

基　　金：国家自然科学基金(编号:81503136);常州市科技计划(应用基础研究)指导性项目(cz20199010)。

摘　　要：目的:探索临床药师参与肾移植术后患者药物治疗管理的工作模式及开展药学监护的方法与重点。方法:总结归纳临床药师在肾移植病房中的临床药学实践和带教工作,并结合具体案例阐述药学监护的重点。结果:初步建立了临床药师在肾移植病房中开展药学服务的工作模式及职责,肾移植术后患者药学监护重点包括耐药菌监控、抗感染治疗方案及药物剂量的制定、药物间相互作用、血药浓度监测及基因检测、药物不良反应监测以及出院后患者用药教育与管理。结论:肾移植患者药物治疗管理工作模式的建立及药学监护的实施,有利于保障患者用药安全、有效,改善患者预后,突显了药学服务的内涵与价值。OBJECTIVE To discuss the working mode of clinical pharmacist participating in medication therapy management of renal transplant recipients and the methods and key points of pharmaceutical care.METHODS The clinical pharmaceutical practice and teaching methods of clinical pharmacist majoring in immune system medication ward were summarized,and the key points of pharmaceutical care were explored through specific cases.RESULTS The working mode and responsibilities of pharmaceutical service in kidney transplantation ward have been basically established.The key points of pharmaceutical care for patients after renal transplantation included the monitoring of drug-resistant bacteria,antimicrobial regiment and dosage design,drug-drug interactions,therapeutic drug monitoring and genetic testing,adverse drug reaction monitoring,and medication education and management for patients after discharge.CONCLUSION The development of medication therapy management mode and the application of pharmaceutical care for renal transplant patients can ensure the safety and effectiveness of treatments.The outcome of patients will be improved while the value of pharmaceutical service will be reflected.

关 键 词：肾移植 药学工作模式 药学监护 

分 类 号：R954[医药卫生—药学]