1例多病共患老年患者的用药分析和药学监护  

Medication Analysis and Pharmaceutical Care for an Elderly Patient with Multiple Diseases

作　　者：冯轶杉 姚慧娟[1] 余自成 陆晓彤[1] Feng Yishan;Yao Huijuan;Yu Zicheng;Lu Xiaotong(Department of Pharmacy,Xinhua Hospital Affiliated to Shanghai Jiao Tong Lniversity School of Medicine,Shanghai 200092,China;Department of Pharmacy,Yangpu Hospital Affiliated to Tongji University)

机构地区：[1]上海交通大学医学院附属新华医院药学部,上海200092 [2]同济大学附属杨浦医院药学部

出　　处：《中国药师》2021年第6期1122-1127,共6页China Pharmacist

基　　金：国家重点研发计划项目子课题(编号:2020YFC2005502)。

摘　　要：探讨临床药师在多病共患住院病例中的药学服务模式。临床药师参与1例老年多病共患患者的治疗过程,及时发现和解决药物治疗问题、消除患者治疗中的药物安全隐患,同时将代谢性疾病领域的最新的循证证据资料和指南应用到临床实践中,在降糖药、调脂药和降尿酸药等药物治疗方面提出优化建议,并提供个体化药学服务。临床药师深入开展全程化药学监护,为优化多病共患患者的药物治疗结局发挥了重要作用。This paper attempts to explore a pharmaceutical care model in which clinical pharmacists provide comprehensive services for inpatients with multiple comorbidities.Clinical pharmacist participated in the whole treatment process of a patient with multiple diseases.Drug related problems were discovered and timely solved,medication safety risks were eliminated,the most recent evidence and guidelines were applied in the clinical practice,and the selection of hypoglycemic agent,hypolipidemic drug and uric acid lowing drug was optimized.Patient-centered pharmaceutical care carried out by clinical pharmacists plays an important role in the rational use of drugs for patients with multiple diseases.

关 键 词：多病共患 老年患者 临床药师 用药分析 药学监护 

分 类 号：K97[历史地理—人文地理学]