循证药学在处理肿瘤患者药物不良反应中的应用

目的：临床药师通过参与临床药物治疗，对肿瘤患者进行药学监护，与临床医师一起在治疗中促进临床合理用药，减少药物不良反应对患者造成的损害。方法：以一位肺癌伴骨转移患者为例，临床药师介入临床，通过循证药学方法，结合临床数据分析唑来膦酸在眼部不良反应发生的原因，预防及治疗措施，并跟踪其效果，对药物治疗过程进行综合的评估。结果：分析检索到的关于唑来膦酸安全性的一个随机对照试验（RCT）和一个回顾性的队列研究以及5例个案并处理患者，患者的眼部不良反应症状消失，同时临床药师向医生及患者解释了不艮反应发生的原因，并且对今后类似患者预防这类不良反应制定了给药计划。结论：临床药师的参与使药物治疗更趋合理。可减少药物的不良反应，使得患者依从性更好，治疗效果更佳。临床药师加入治疗团队，参与临床治疗实践，对患者进行治疗监护，有利于提高临床的药物治疗水平。

Application of Evidence based Pharmacy in Handling Adverse Drug Realtion of Tumor Patients

Objective：To understand the clinical drug therapy and pharmaceutical care for patients and cooperation with clinicians by clinical pharmacists in order to promote rational drug use in clinics and reduce the damage of ADR to tumor patients. Methods：Taking a lung cancer patient for instance, clinical pharmacists evaluated his quality of data, analyzed the cause of ocular ADR and made their pceventive therapeutic measures and systematic evaluation of medicine therapeutic process by retrieving relevant databases and clinical dates. Results：One RCT, one retrospective cohort study and five case reports about security were obtained. The symptoms of ocular ADR disappeared from them. Clinical pharmacists explained why the ADR occurred, and made schedule to prevent similar damages in further zoledronic acid＇ s usage. Conclusion：The participation of clinical pharmacists made the drug treatment more rational, patients more compliant and adverse drug reactions reduced. The participation of clinical pharmacists in a clinical treatment team and clinical practice to provide their pharmaceutical care for patients could help to improve the level of clinical drug treatment.