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| 临床药师对1例慢性再生障碍性贫血患者的药学监护 |
| Pharmaceutical Care by Clinical Pharmacists on One Patients with Chronic Aplastic Anemia |
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| DOI： |
| 中文关键词: 慢性再生障碍性贫血 环孢素 药源性疾病 治疗药物监测 药学监护 |
| 英文关键词:Chronic aplastic anemia Cyclosporine Drug induced disease Therapeutic drug monitoring Pharmaceutical care |
| 基金项目:上海市医院药学科研基金课题（编号：2011YY0101）；上海市医院药学科研基金课题（编号：2011YY0433）；长海医院1255药剂建设计划(编号：CH125520400) |
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| 中文摘要: |
| 摘 要 目的:分析和总结临床药师对1例慢性再生障碍性贫血（CAA）患者的长期药学监护过程，优化CAA患者的药学监护和个体化给药方案，提高对患者治疗药物监测（Therapeutic drug monitoring，TDM）与药学服务质量。方法：对该患者的病史资料、临床生化指标和随访环孢素（CsA）的TDM数据进行归纳和分析，以CsA引起的牙龈增生和肾功能损伤等药源性疾病为切入点，对患者进行药学监护和干预。结果：该患者在CsA等对症治疗过程中发生了牙龈增生、肾功能损伤、多毛症和月经不调等严重药源性疾病。临床药师干预后，患者的血CsA浓度趋于平稳，牙龈增生好转，肾功能逐渐恢复。结论：使用CsA等免疫抑制药治疗的CAA患者，应定期进行TDM，并在临床药师的指导下安全、有效的使用对症的免疫抑制剂，及时调整用药方案，以提高治疗效果和降低不良反应的发生率。 |
| 英文摘要: |
| ABSTRACT Objective:To optimize pharmaceutical care and individualized dosing regimen for chronic aplastic anemia（CAA） patients and enhance the quality of therapeutic drug monitoring through analyzing the long term pharmaceutical care of a CAA patient. Methods:The drug induced disease caused by CsA,such as gingival hyperplasia and renal dysfunction,etc,as a starting point, were taken；patient's medical history, biochemical index and the TDM data of CsA were generalized and analyzed, suitable pharmaceutical care and intervention for the patient were conducted. Results:Serious drug induced diseases occurred in the therapeutic process of CsA as gingival hyperplasia，renal dysfunction hypertrichosis，irregularity of menstruation,etc, had been partially reliefed after medical intervention.Conclusion:Patients treat with the immunosuppressive agent such as CsA should be under therapeutic drug monitoring and the guidance of clinical pharmacists, and adjust their medical programmes in time,in order to increase the therapeutic effect and reduce the adverse drug reaction rate. |
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