1例慢性阻塞性肺疾病患者的药学监护

目的：探讨临床药师参与药物治疗方案的制订与药学监护的方法。方法：参与1例慢性阻塞性肺疾病急性加重期合并房颤、高血压患者个体化治疗方案的制定，分析患者住院期间药物治疗的合理性。结果与结论：临床药师从抗感染药物、支气管舒张剂、抗凝药、降压药物作为切入点开展药学监护，及时发现和解决了患者药物治疗的问题，为临床合理用药提供了意见。临床药师的参与可以协助医师制订安全、有效的治疗方案。

Pharmaceutical Care of a Patient with Chronic Obstructive Pulmonary Disease

Objective：To explore the way for clinical pharmacist ’ s participating in designing drug therapy scheme and pharmaceutical care . Methods： To participate in formulating an individualized therapy plan for a pa-tient with acute exacerbation of chronic obstructive pulmonary disease （ AECOPD ） complicating with atrial fibrillation and hypertension , and to analyze the rationality of drug therapy during hospitalization . Results ＆amp; Conclusion： Clin-ical pharmacist can perform pharmaceutical care by putting forward suggestions on the drug application as the start-ing point such as the drugs for anti-infection , bronchodilatation , anticoagulant and hypotensive , timely discover and solve problems in drug treatment of patient, and provide advices for clinical rational drug use. Clinical pharmacist ’s involvement can provide a help to physician to develop a safe and effective treatment plan .