1例艾滋病伴自身免疫性溶血性贫血及多种机会性感染患者的药学监护

目的 通过药师在1例艾滋病伴自身免疫性溶血性贫血及多种机会性感染患者治疗过程中的药学监护，探讨药师在临床治疗中的作用。方法 临床药师查阅诊疗资料，指导糖皮质激素类药物合理使用；监测抗结核药物的不良反应，分析患者胆红素变化，识别药物性肝损伤，协助医师调整抗结核治疗方案；关注依非韦仑和利福平的药物相互作用，与医师探讨是否调整依非韦仑的剂量；研读Epstein-Barr病毒感染治疗的研究资料，评估更昔洛韦的疗效。结果 通过药学监护，提高了患者用药的安全性及有效性。结论 临床药师应切实发挥专业优势，促进合理用药，为患者提供药学服务。

Pharmaceutical Care for One Patient with AIDS Accompanied by Autoimmune Hemolytic Anemia and a Variety of Opportunistic Infection

OBJECTIVE To analyze pharmaceutical care for a patient with AIDS accompanied by autoimmune hemolytic anemia and a variety of opportunistic infection, and to investigate the role of clinical pharmacists in the clinical treatment. METHODS Clinical pharmacists consulted clinical data to guide the rational use of glucocorticoid; monitored the adverse reaction of anti-tuberculosis drugs, analyzed the changes of bilirubin, identified drug induced liver injury, assisted doctors to adjust the therapeutic regimen of anti-tuberculosis; paid attention to drug interaction between the efavirenz and rifampin, and discussed with doctors whether to adjust dosage of the former; learnt the research data of Epstein-Barr virus infection treatment, and evaluated the efficacy of ganciclovir. RESULTS With pharmaceutical care, pharmacists improved the safety and effectives. CONCLUSION Clinical pharmacists should give full play to their professional advantages, promote rational drug use, and provide pharmaceutical service for patients.