陶兴茹(郑州市儿童医院药学部，河南 郑州　450053)



临床药师参与1例呼吸科患儿的药学监护

陶兴茹*(郑州市儿童医院药学部，河南 郑州450053)

DOI10.14009/j.issn.1672-2124.2016.02.043

摘要目的：通过临床药师对1例呼吸科患儿实施药学服务的过程，探讨临床药师参与抗感染治疗与开展药学监护的方法。方法：回顾性分析临床药师参与1例呼吸科患儿抗感染治疗的案例，根据呼吸科疾病药物治疗特点，分析临床药师为该类患儿实施药学监护的要点。结果:临床药师可以把参与制订抗感染治疗方案、药品不良反应、出院注意事项、预防并发症等方面作为该类患者药学监护的要点。结论:药学监护已经成为医疗过程中不可缺失的一部分，医、药、护间应相互协助，以提高治疗效果，促进临床合理用药。

关键词氟康唑； 不良反应； 药物热； 临床药师； 药学监护

Clinical Pharmacists’ Practice in Pharmaceutical Care for One Child with Respiratory Diseases

TAO Xingru1(Dept.of Pharmacy, Zhengzhou Children’s Hospital, Henan Zhengzhou 450053, China)

ABSTRACTOBJECTIVE：To probe into the approach of participating in anti-infection treatment and pharmaceutical care by clinical pharmacists, through the process of pharmaceutical care for one child with respiratory diseases. METHODS: Retrospective analysis was conducted on one case of anti-infection treatment participated by clinical pharmacists, and then the key points of pharmaceutical care for such children were analyzed according to the characteristics of respiratory disease drugs. RESULTS: Clinical pharmacists could set anti-infection treatment scheme, adverse drug reactions, discharge precautions and prevention of complications as the key points of pharmaceutical care in such clinical symptoms. CONCLUSIONS: Pharmaceutical care has become a significant part of the medical process. Physicians, pharmacists and nurses are suppose to assist each other, so as to improve the clinical treatment effects and promote rational drug use in clinic.

KEYWORDSFluconazole; Adverse Drug reactions; Drug fever; Clinical pharmacists; Pharmaceutical care

1病例资料

患者，女性，4岁5个月，体质量14.5 kg，既往有胆囊管囊肿手术史。术后10个月再次入院治疗，本次入院主要原因为发热6 d，热峰39.3 ℃，院外给予口服“双黄连口服液、利巴韦林颗粒”等药物治疗3 d(2014.6.8—2014.6.10，具体用法、用量不详)，静脉滴注“头孢他啶0.75 g、1日2次，热毒宁7 ml、1日1次”2 d(2014.6.11—2014.6.12)，治疗效果差。入院查体：体温37.5 ℃，心率126次/min，呼吸 32次/min，患儿神志清，精神反应较差，饮食、睡眠稍差，呼吸稍促，伴有流清涕，咽充血，双侧扁桃体Ⅰ°肿大，双肺呼吸音粗。辅助检查：血常规:白细胞计数16.46×109/L，淋巴细胞百分比 69.9%，中性粒细胞百分比27.3%，血红蛋白112.0 g/L，血小板计数297×109/L，C反应蛋白1.0 mg/L；肺炎支原体抗体：阴性。呼吸道合胞病毒-IgM 阳性(+)，真菌D-葡聚糖检测 506.7 pg/ml；红细胞沉降率24 mm/h；……