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摘 要 目的:探讨临床药师在化疗致Ⅳ骨髓抑制病例中开展临床药学的切入点及药学监护方法。方法: 以对1例培美曲塞联合奈达铂用于晚期肺腺癌出现Ⅳ度骨髓抑制的病例分析为切入点,对该例患者化疗方案、骨髓抑制的发生及治疗过程及可开展的药学服务进行分析总结。结果: 临床药师利用药学专业知识最终帮助患者安全度过化疗后的骨髓抑制期,增强了药学监护意识,为保障患者用药安全有效等方面发挥了积极作用。结论:临床药师积极参与药学监护,提供药学服务,有利于患者用药安全、有效。 相似文献
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摘 要 目的:为临床药师对化疗药物引起的重度骨髓抑制合并感染患者的药学监护提供参考。方法: 临床药师参与1例胆管癌术后复发患者化疗后重度骨髓抑制合并肺部感染的监护过程。从化疗方案的评估、骨髓抑制的对症治疗、骨髓抑制后的抗感染治疗等方面提出药物建议。 结果: 患者骨髓抑制得以缓解,肺部感染好转,未发生其他严重不良反应。结论:临床药师通过提供个体化用药方案,提高了重度骨髓抑制患者的治疗效果及用药安全性。 相似文献
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目的:探讨临床药师对伴发肝损害、药物性重度骨髓抑制合并肺部感染的癌症患者实施药学监护的切入点。方法:临床药师通过参与1例肝胆管细胞癌患者应用GP方案(吉西他滨+顺铂)化学治疗后出现药物性重度骨髓抑制合并肺部感染的治疗,分析导致重度骨髓抑制的原因,协助医生合理选择药物并实施药学监护。结果:患者的骨髓抑制及感染症状缓解,体温恢复正常,无血小板减少性出血等其它药物不良反应事件发生。结论:GP方案易导致严重骨髓抑制,因此,在化疗前应重视风险评估,适时调整药物剂量,尽量避免或减少不良反应的发生。临床药师应注重个性化药学监护,保障患者用药安全合理。 相似文献
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摘 要 目的:探讨临床药师在治疗重度骨髓抑制的肿瘤患者中实施药学监护的意义。方法: 临床药师利用药学专业知识,结合检验结果、药敏结果、药物特点、用药经验及药物不良反应等方面的知识协助医生合理选择药物并实施药学监护。结果:通过对该患者实施全程的药学监护,与医生良好的配合,提高了用药的科学性、合理性,同时提高了患者的依从性,最终顺利的完成治疗。结论:临床药师通过对患者的药学监护,可以协助临床避免不良事件的发生,使患者用药更加安全、有效和合理。 相似文献
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摘 要 目的:为临床药师参与晚期乳腺癌患者治疗的药学监护提供参考。方法: 临床药师通过参与晚期乳腺癌骨转移伴癌痛患者的药物治疗实践,根据患者具体情况进行用药分析和药学监护,并提供合理的个体化治疗建议。结果: 临床药师利用药学专业知识,在镇痛、化疗及双膦酸盐治疗中进行分析并提出建议,保障患者用药安全有效。结论: 临床药师通过用药分析和药学监护,可保障患者药物治疗更加安全有效。 相似文献
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目的:为了使并发肺部感染的病人更多、更好、更早的痊愈。方法:通过对32例颅脑外伤并发肺部感染病人的严密观察,采取更换体位、超声雾化、有效排痰训练等有效的护理措施干预,从而控制了肺部感染。结果:痊愈17例,占53.1%;显效12例,占37.5%,无效2例,占6.2%;死亡1例,占3.1%;实践证明,有效的护理干预对提高患者治疗成功率有着重要意义。 相似文献
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1例78岁男性患者因带状疱疹神经痛、慢性阻塞性肺疾病合并感染,给予头孢唑肟钠(2.25 g静脉滴注,1次/d)、卡马西平(0.2 g口服,2次/d)、尼美舒利(100 mg口服,2次/d)、二羟丙茶碱(0.5 g静脉滴注,1次/d)、甲钴胺(0.5 mg口服,3次/d)、地塞米松(5 mg,静脉滴注1次)、盐酸哌替啶(25 mg,肌内注射1次)和盐酸布桂嗪(100 mg,肌内注射3次)等药物治疗。第7天,停用头孢唑肟钠,改为磷霉素钠(8 g静脉滴注,1次/d)。第11天,血常规检查示白细胞计数1.6×10^9/L,中性粒细胞0.03,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.9×10^9/L。立即停用所有药物,给予对症支持治疗。第15天,外周血白细胞计数0.9×10^9/L,中性粒细胞0.02,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.7×10^9/L。行骨髓穿刺检查,诊断为粒细胞缺乏症。第17天患者出现右肺气胸、肺不张。第20天出现急性呼吸衰竭、多脏器衰竭合并重症感染,经抢救无效死亡。 相似文献
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P. Kendrew F. Ward D. Buick D. Wright R. Horne P. Kendrew F. Ward 《The International journal of pharmacy practice》2001,9(Z1):5-5
□ Due to the nature of chronic pain it would be expected that patients are highly adherent to their pain medication. However, results from this study have shown that 23 per cent of patients often or always avoid using their pain medication, 13.4 per cent often or always alter dosages, and 10.3 per cent often or always stop taking their medication for a while. This suggests intentional non‐adherence to pain medication □ Less than 50 per cent of respondents were satisfied with information provided on side effects, what to do if side effects occur, and possible interactions with other medication □ Patients' satisfaction with information about their medication was related to self‐reported adherence; greater satisfaction was associated with higher self‐reported adherence 相似文献
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Genomic profiling associated with recurrence in patients with rectal cancer treated with chemoradiation 总被引:1,自引:0,他引:1
Gordon MA Gil J Lu B Zhang W Yang D Yun J Schneider S Groshen S Iqbal S Press OA Rhodes K Lenz HJ 《Pharmacogenomics》2006,7(1):67-88
PURPOSE: Stage II and III adenocarcinoma of the rectum has an overall 5-year survival rate of approximately 50%, and tumor recurrence remains a major problem despite an improvement in local control through chemotherapy and radiation. The efficacy of chemoradiation therapy may be significantly compromised as a result of interindividual variations in clinical response and host toxicity. Therefore, it is imperative to identify those patients who will benefit from chemoradiation therapy and those who will develop recurrent disease. In this study, we tested whether a specific pattern of 21 polymorphisms in 18 genes involved in the critical pathways of cancer progression (i.e., drug metabolism, tumor microenvironment, cell cycle regulation, and DNA repair) will predict the risk of tumor recurrence in rectal cancer patients treated with chemoradiation. PATIENTS AND METHODS: A total of 90 patients with Stage II or III rectal cancer treated with chemoradiation were genotyped using polymerase chain reaction (PCR)-based techniques for 21 polymorphisms. RESULTS: A polymorphism in interleukin (IL)-8 was individually associated with risk of recurrence. Classification and regression tree analysis of all polymorphisms and clinical variables developed a risk tree including the following variables: node status, IL-8, intracellular adhesion molecule-1, transforming growth factor-beta, and fibroblast growth factor receptor 4. CONCLUSION: Genomic profiling may help to identify patients who are at high risk for developing tumor recurrence, and those who are more likely to benefit from chemoradiation therapy. A larger prospective study is needed to validate these preliminary data using germline polymorphisms on tumor recurrences in rectal cancer patients treated with chemoradiation. 相似文献
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目的 对类风湿关节炎合并肺间质纤维化患者的临床特征进行分析,为今后的临床诊治工作提供可靠的参考依据.方法 选取2010年1月-2013年3月我院收治的类风湿性关节炎患者102例,按照是否合并肺间质纤维化分成合并组和单纯组,而后对这两组的临床观察指标进行对比分析.结果 合并组患者的男性所占比例、吸烟者比例、患者年龄、发病年龄、抗环瓜氨酸抗体、类风湿因子、C反应蛋白水平以及骨破坏发生率均较单纯组高.结论 类风湿关节炎患者合并肺间质纤维化可能与诸多临床指标均存在较大的相关性,临床应给予关注,采取有效措施进行预防和治疗. 相似文献