对1例肾移植患者基于药物基因多态性检测及血药浓度监测的个体化药学监护

免疫抑制药在肾移植术后抗排斥反应中广泛应用,但具有治疗窗窄、不良反应大、药动学及药效学个体差异显著等特点。为提高肾移植术后患者药物治疗效果,降低药品不良反应发生,临床药师运用药物基因多态性检测及血药浓度监测等手段对1例肾移植术后患者的个体化用药监护,阐述了肾移植术后患者使用免疫抑制药出现的用药问题,如药物治疗效果、药品不良反应、药物相互作用等。通过临床药师的药学监护,提高了肾移植术后患者用药的安全性和有效性,协助临床医师更好地为患者实施个体化用药,切实体现临床药师的价值。

Individual Pharmaceutical Care for a Kidney Transplant Patient Based on Detection of Drug Gene Polymorphism and Monitoring of Blood Drug Concentration

Immunosuppressive drugs are widely used for anti-rejection after kidney transplantation,while they are characterized by narrow therapeutic window,large toxic and side effects,and significant individual differences in pharmacokinetics and pharmacodynamics.In order to improve the effect of drug treatment for patients after kidney transplantation and reduce the occurrence of adverse drug reactions,clinical pharmacists used the detection of drug gene polymorphism and the monitoring of blood drug concentration to monitor the individual medication of one patient after kidney transplantation,and expounded the medication problems of immunosuppressive drugs used in the patient after kidney transplantation,such as the drug treatment effect,adverse drug reactions and drug interactions,etc.Through the pharmaceutical care of clinical pharmacists,the safety,rationality and effectiveness of medication for patients after kidney transplantation are improved,and clinicians are assisted to better implement personalized medication for patients,which effectively reflects the value of clinical pharmacists.