临床药师参与1例药物性肝损伤患者的药学监护

摘 要 目的：探讨临床药师参与药物性肝损伤实施因果分析和药学监护的过程、方法及其作用。方法：临床药师通过RUCAM评估量表对1例药物性肝损伤患者进行因果关系分析，协助医师制定用药方案，排查可能引起急性肝损伤的药物，协同医生详细询问患者既往用药史，建立详细用药清单，在护肝治疗同时加强对患者肝功能的监护。结果与结论：临床药师结合患者的临床症状、实验数据和药物作用特点等情况提出建议，使患者症状得到改善，病情得到控制。临床药师通过实施药学监护，协助医师优化治疗方案，减少不必要的药物联用，减少了药物性肝损伤的发生。

Pharmaceutical Care for a Case of Drug Induced Liver Injury by Clinical Pharmacists

ABSTRACT Objective:To discuss the processes, methods and roles of clinical pharmacists providing causality assessment and pharmaceutical care for patient of drug induced liver injury.Methods:The causality assessment for a drug induced liver injury patient using RUCAM scale was analyzed by clinical pharmacists. Clinical pharmacist provided pharmaceutical care such as optimization of therapeutic plans, investigation of possible drugs with DILI. On the basis of inquiry of the detailed medication history of the patient together with the physicians, the clinical pharmacists established the detailed list of drugs. Meanwhile, the pharmaceutical care for liver function and the treatment for liver protection were strengthened, and the patient recovered quickly.Results and Conclusion:On the basis of the patient''s clinical symptoms, the experimental data, and the characteristics of the drug, and so on and so forth, the clinical pharmacists made the suggestions and gave the advice to the physicians, which made the patients symptoms improved and the illness under control. Through the implementation of pharmaceutical care, clinical pharmacists can assist physicians in optimizing the treatment regimen, reducing unnecessary drug combination, improving treatment effect and reducing the incidence of drug induced liver injury. Clinical pharmaceutical care promoted the effectiveness and safety of drug use, and improved patients'' and dependents'' compliance. The participation of pharmacists in pharmaceutical care contributed to the rationality and safety of drug use and improved patients'' compliance.