糖尿病足局部治疗的药学服务探讨

目的探讨临床药师参与糖尿病合并糖尿病足患者局部用药方案的实践与体会。方法临床药师分析3例糖尿病足患者药物治疗方案,为临床医师提供合理用药建议。结果药师发挥药学专长,提出合理的药物治疗建议,使患者治疗用药更加合理规范,减少了药品不良反应的发生,提高了药物治疗水平。结论临床药师提供药学服务在糖尿病足局部治疗合理用药中有重要意义。     

临床药师参与1例甲硝唑中毒救治的药学实践

摘 要本文通过临床药师参与1例甲硝唑中毒救治的药学实践,探讨药物急性中毒救治中临床药师的作用。临床药师结合中毒药物的特征协助医师制定了血液净化方案、结合相关指南和循证医学证据优化了保肝药物治疗方案、对应激性溃疡防治药物的选择和方案调整提出了具体意见,并为患者提供了肝素的个体化用药方案和用药监护,使患者得到合理救治。提示在药物急性中毒患者的治疗中,临床药师应及时提供中毒药物信息,全程参与患者的药物治疗,提出建议,优化用药方案,临床药师在治疗团队的作用不容忽视。     

临床药师对二例糖尿病合并脓毒症患者的药学监护

目的探讨临床药师在糖尿病合并脓毒症患者治疗中的作用。方法临床药师参与2例糖尿病合并脓毒症患者的治疗,对抗感染药物治疗方案的制订提出了具体意见,结合患者的实际情况以及当前治疗方案的临床疗效,提出延长美罗培南输注时间的建议;临床药师在查房过程中及时干预中药注射剂的不合理用药,并在益生菌制剂的选择上提出了合理的建议。结果 2例糖尿病合并脓毒症患者的药物治疗有效,患者治愈出院。结论临床药师通过实施药学监护,协助医师优化治疗方案,减少了药物不合理应用,提高了临床药物治疗的有效性和安全性。     

92例老年肺部感染患者抗菌药物合理应用分析

［摘要］目的探讨合理使用抗菌药物治疗老年肺部感染。方法呼吸科＞60岁老年肺部感染住院患者92例,对其抗菌药物使用情况进行调查分析,提出合理化建议。结果92例中存在抗菌药物使用不当的问题,临床药师对此作出用药指导,提出合理化建议。结论临床药师应参与老年肺部感染患者治疗,以促进抗菌药物的合理应用。     

临床药师参与羊水栓塞患者的药物治疗实践

目的探讨临床药师在羊水栓塞患者治疗中的作用。方法临床药师参与羊水栓塞患者的治疗过程,从给予糖皮质激素、抗凝血药物、抗感染药物、质子泵抑制剂等方面提出合理建议。结果避免了治疗中的潜在风险,保证了患者用药安全。结论临床药师参与临床药物治疗实践,有利于临床合理用药水平的提高。     

糖尿病合并高血压患者的降压治疗药学服务

目的:探讨临床药师参与糖尿病合并高血压患者的临床会诊并制订用药方案的实践与体会。方法:根据患者病理生理情况,结合相关治疗指南和专家共识,分析3例糖尿病合并高血压患者药物治疗方案的制订,为临床医师提供合理用药建议。结果与结论:药师发挥药学专长,提出合理的药物治疗建议,使患者的血糖和血压维持在正常的范围,减少了药品不良反应的发生,提高了药物治疗水平。     

1例铅黄肠球菌尿路感染的用药分析

临床药师参与1例铅黄肠球菌导致的尿路感染患者治疗，予哌拉西林钠他唑巴坦钠经验性治疗后效果不佳，根据药敏结果应用替考拉宁，但患者出现血小板减少的少见不良反应。临床药师根据感染病原菌特点及药物的肾脏浓度，建议给予患者达托霉素抗感染治疗，患者病情逐渐好转。在本案例中，临床药师将药学理论与临床实践相结合，从临床诊断、药物合理选择及治疗方案调整等方面提出合理建议，使患者感染得到控制。临床药师的参与，促进了临床合理用药，对患者治疗起到了积极作用。     

晚期胃癌患者的药物治疗分析

目的:结合肿瘤专科临床药物治疗特点,探索临床药师评价药物治疗方案、提供药学监护的思路。方法:分析1例晚期胃癌患者的病情特征及治疗原则,对药物治疗方案进行分析评价,并给出药学监护计划。结果:临床药师可通过对患者的药学监护,为临床药物治疗提供合理化建议。结论:临床药学监护对促进临床合理用药有积极作用。     

临床药师参与肿瘤科乳腺癌序贯辅助化疗的实践与分析

从临床药师角度分析1例早期乳腺癌患者保乳术后的病情特征、治疗原则,利用药学理论和循证药学,与医师共同讨论治疗方案,并对方案进行评价与调整,从入院到出院实施药物监护计划。临床药师通过病例跟踪分析,可以发现临床药物治疗中需注意的问题,提出合理建议。此举有利于与医护人员形成综合治疗团队。     

1例脑外伤术后肺部感染患者抗菌药物使用分析

介绍临床药师参与1例脑外伤术后肺部感染患者的抗菌药物治疗过程。临床药师通过协助医师遴选抗菌药物,对临床药物治疗提出建议,避免或减少了抗菌药物过度使用;临床药师通过总结抗菌药物使用经验,促进了临床合理用药,在临床药物治疗中发挥了积极作用。     

临床药师在晚期帕金森病伴复杂运动并发症中的药学服务

目的探讨临床药师在晚期帕金森病伴复杂运动并发症中的药学监护。方法临床药师参与1例晚期帕金森病伴复杂运动并发症治疗的案例,分析总结临床药师在该疾病治疗中的药学服务模式。结果临床药师对该患者的药物选择进行了分析及建议,并对药物治疗中出现的不良反应进行了处理和监护的综合管理,使患者的症状得到了改善。结论临床药师为帕金森病患者提供药学服务,可有效提高患者用药安全。     

A patient‐held medication record and a patient medication profile to support the continuity of acute cancer care

□ The sharing of care of patients receiving medical oncology care is vulnerable to errors in their documented drug history □ A patient‐held medication record identified over 90 per cent of patients' medications but was ‘forgotten’ by the patient in a third of contacts with a pharmacist □ Discrepancies between the medication records of GPs, community pharmacists and the medical oncology clinic were highly prevalent □ A posted patient medication profile issued by the hospital pharmacist to both the patient's GP and their community pharmacist was associated with a significant convergence in their records (discrepancies reduced from 17 to 6 % P<0.001) □ The patient‐held record had little impact on the accuracy of practitioners' records and its value lies more in facilitating patient education than rectifying errors in documentation     

Factors influencing patient participation in medication counseling at the community pharmacy: A systematic review

BackgroundFindings document that patient participation in pharmacy encounters is associated with favorable outcomes. However, there is a need to understand factors that may enhance or hinder patient engagement and pharmacist counseling behaviors during their medication discussions. This review aims to: (1) identify barriers and facilitators for patient engagement in pharmacy consultations, (2) explore the relationship between patient factors (such as demographics and communication behavior) and subsequent pharmacist counseling behavior.MethodsA systematic review of literature using PRISMA guidelines examined studies published in English addressing influences on patient participation and the relationship between patient factors and pharmacist counseling behavior. Four databases were used - PubMed, CINAHL, PsycINFO, and Scopus. Findings were framed thematically within the constructs of Street's Linguistic Model of Patient Participation in Care (LM).FindingsFifty studies from 1983 to 2019, including 37 using self-reported data, were identified. Patient involvement in patient-pharmacist communication was influenced by enabling factors such as patient knowledge, communication skills, and pharmacy environment. Predisposing factors for participation ranged from patients' beliefs and past experiences to demographic characteristics such as gender and age. Pharmacists' participative behavior with patients was positively associated with patients’ engagement and perceived patient cues in the conversation.ConclusionThis systematic review identified predictors of patients' engagement in pharmacy encounters drawing on LM framework. Various predisposing factors, enabling factors, and pharmacist’ responses impacted patients' willingness to actively participate in medication counseling at community pharmacies. Equally important, studies documented considerable impact by patients on pharmacists' counseling behavior. Pharmacy encounters should no longer be viewed as controlled simply by pharmacists’ expertise and agendas. Patient characteristics and factors such as patient question-asking and expectations also appear to be associated with and influence patient-pharmacist interpersonal communication. Additional research needs to address the identified facilitators and barriers to enhance patient participation and pharmacist counseling behavior.     

1例粒细胞缺乏伴发热患者抗感染治疗的药学监护

目的交流临床药师对粒细胞缺乏伴发热患者抗感染治疗的药学监护体会。方法临床药师根据患者各项指标和生命体征变化,协助临床医师制订抗感染方案,提出合理用药建议,对患者进行用药宣教,并追踪药物疗效和不良反应。结果患者的感染得到很好控制,并有效地避免了ADR的发生。结论通过临床药师的药学监护,粒细胞缺乏伴发热患者的感染得到控制,患者生活质量得以提高。     

中西医结合治疗冠心病心绞痛的疗效分析

目的对冠心病心绞痛患者采用中西医结合治疗,探讨和分析其治疗的临床效果。方法对我院收治的80例冠心病心绞痛患者,按照随机数字表法进行分组,分为试验组和对照组,各为40例。对照组:采用常规西医治疗;试验组:在对照组常规治疗基础上采用中药治疗。结果试验组治疗有效率为90.0%明显高于对照组62.5%,差异有统计学意义(P<0.05)。结论在临床上,对冠心病心绞痛患者在西医基础上加用中药治疗,有效地改善患者的症状,减轻患者的心绞痛等症状,提高患者的生活质量,值得在临床上进行推广和应用。     

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。     

Patient Education in 20 Dutch Community Pharmacies: Analysis of Audiotaped Patient Contacts

The level of patient education activity in Dutch community pharmacies was examined. A total of 200 hours' audiotapes of pharmacy patient contacts were collected in a selective sample of 20 community pharmacies. All pharmacists involved were selected on the basis of their interest in developing patient education in their pharmacies. The outcome measure was the percentage of patient contacts which included the provision of oral drug information. Both pharmacists and technicians participated in the audiotapes and their behaviour at the counter was compared. The results demonstrated that the provision of oral drug information was concentrated on contacts where patients collected drugs, and the contents of the information mainly concerned drug instructions. The pharmacists provided significantly more frequent oral drug information than the technicians. No differences were found in the frequency of provision of oral drug information to female and to male patients, or to patients and to relatives collecting the drug. Mostly the oral drug information was given without patients' questioning. The effects of these kind of activities on patients' drugs use are questioned because it is known that efforts to increase patient compliance should meet the educational principles of individualisation. Therefore, the development of patient instruction into patient education remains a challenge to pharmacists in the future.     

1例帕金森病伴部分精神障碍患者的用药分析和药学监护

目的 探讨临床药师在帕金森病伴部分精神障碍患者治疗过程中的作用。方法 临床药师结合患者疾病特点、用药史、药物相互作用及药品不良反应等情况,对患者进行药学监护并提出优化治疗方案的建议。结果 临床药师参与患者治疗方案的制订,进行用药指导和出院教育,促进合理用药。结论 临床药师可利用自身专业知识,积极参与临床药物治疗工作,协同医师优化临床给药方案。     

1例螺内酯致男性肝硬化患者乳房发育的不良反应分析

目的 分析1例男性肝硬化患者服用螺内酯后出现乳房发育的不良反应,探索可能原因,提高药学服务水平。方法 临床药师结合患者的基础疾病、用药史等诊疗经过,查找国内外相关文献,对不良反应产生原因进行分析。结果 患者停用螺内酯后,乳房疼痛减轻至消失,推测螺内酯是导致患者乳房发育的可疑药物。结论 临床药师通过关注药品不良反应,可以为临床提供药物信息和更好的药学服务。