四例氯吡格雷致白细胞和中性粒细胞减少患者的药学服务

目的探讨临床药师在氯吡格雷致白细胞和中性粒细胞减少患者中如何提供药学服务。方法临床药师通过参与4例氯吡格雷导致的白细胞和中性粒细胞减少患者的治疗,根据药学相关知识及阅读相关文献,及时判断导致白细胞减少的可疑药物,并提供替代药物及对症治疗药物,通过定期血常规检查结果逐步调整治疗方案,并积极治疗原发病与伴发的感染,参与并监护患者用药的全过程。结果在临床医生和临床药师的共同合作下,4例患者的白细胞逐渐回升至基线水平,伴发感染与原发疾病也得到合理的治疗,患者病情好转后全部安全出院。结论临床药师要充分发挥自己药学专业的优势,在临床工作中及时辨别药物的不良反应,协助临床医生更好地使用药物,为患者提供更好的药学监护。

Pharmaceutical care for four patients with clopidogrel-associated leukopenia and neutropenia

Objective To explore the pharmaceutical care approaches for patients with clopidogrel-associated leukopenia and neutropenia by clinical pharmacists. Methods Clinical pharmacists participated in the treatment of 4 patients with clopidogrel-associated leukopenia and neutropenia,determined the suspected drug causing leukopenia and provided alternative drugs and symptomatic treatment by using pharmacy-related knowledge and reading literature. The treatment plan was adjusted gradually according to the periodic blood test results,then the medication of patients was monitored,and the primary disease and associated infection was treated aggressively. Results With the cooperation of clinical pharmacists and physicians,the white blood cells of four patients gradually rose to its baseline level,and the as-sociated infection and primary disease were treated reasonably. Patients′condition was improved after being discharged. Conclusion Clinical pharmacists should give full play to their own advantages of pharmacy,identify adverse drug re-actions timely in the clinical work,help clinicians make better use of drug,and provide better pharmaceutical care for patients.