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抗肿瘤药物药学监护路径的建立和应用
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| 篇名： | 抗肿瘤药物药学监护路径的建立和应用 |
| TITLE： | |
| 摘要： | 目的：为肿瘤科临床药师开展药学监护提供新思路。方法：应用临床路径的原理和方法，按给药的时间顺序将抗肿瘤药物的药学监护工作分为给药前、给药时、给药后和患者教育等4个单元，以循证医学为依据制订各单元的监护内容，建立抗肿瘤药物药学监护路径（PCP）。在1例肝功能受损的乳腺癌转移患者的化疗过程中，临床药师以抗肿瘤药物唑来膦酸、表柔比星和紫杉醇的PCP为导向，先后提出补充钙剂、调整表柔比星和紫杉醇的剂量等用药建议，并开展药物预处理、药品不良反应监测及处理等药学监护和患者教育。结果：医师采纳临床药师建议。该患者在化疗过程中出现关节和肌肉疼痛，经塞来昔布对症治疗后逐渐缓解；化疗后其胸背部不适感明显缓解，病情稳定，准予出院。结论：PCP注重监护的时间、内容和对策，注重监护的计划性和治疗结果，可促进药学监护工作的标准化、规范化、简单化和流程化。临床药师以PCP为导向，有针对性地快速开展个体化药学监护，加深了临床药师与医护人员和患者间的沟通交流，有助于临床药学工作的顺利开展。 |
| ABSTRACT： | OBJECTIVE： To provide the new idea for clinical pharmacists providing pharmaceutical care in oncology department. METHODS： Applying the principles and methods of clinical pathway， the pharmaceutical care of anti-tumor drugs could be divided into before medication， during medication， after medication and patient education， according to the sequence of taking medicine. On the basis of evidence-based medicine， the care contents of each unit were established， and the pharmaceutical care pathway （PCP） was formed. During chemotherapy duration for a breast cancer metastasis patient with liver function injury， clinical pharmacists conducted pharmaceutical care for drug pretreatment， ADR monitoring and disposal， patient education， as well as put forward the proposal of drug treatment as supplementing calcium， adjusting the dose of epirubicin and paclitaxel targeting on PCP of zoledronic acid， epirubicin and paclitaxel. RESULTS： Physicians adopted the pharmacist’s recommendations. The patient suffered from joint and muscle pain during chemotherapy， and the symptom was relieved after symptomatic treatment by celecoxib； chest and back discomfort was relieved significantly after chemotherapy， and the disease condition kept stable. The patient was discharged from the hospital. CONCLUSIONS： PCP focus on the time， content and countermeasures of pharmaceutical care， the program and treatment results of pharmaceutical care， and promote standardization， formalization， simplification and procedure of pharmaceutical care. Clinical pharmacists conduct individualized pharmaceutical care rapidly targeting on PCP so as to deepen the communication of clinical pharmacists with physicians， nurses and patients， and promote the development of pharmaceutical care smoothly. |
| 期刊： | 2016年第27卷第35期 |
| 作者： | 曾卫强，曲云婷，闫其星，赵德华，劳海燕，曾英彤，杨敏 |
| AUTHORS： | ZENG Weiqiang，QU Yunting，YAN Qixing，ZHAO Dehua，LAO Haiyan，ZENG Yingtong，YANG Min |
| 关键字： | 临床药师；抗肿瘤药物；药学监护；药学监护路径 |
| KEYWORDS： | Clinical pharmacist； Anti-tumor drugs； Pharmaceutical care； Pharmaceutical care pathway |
| 阅读数： | 1448 次 |
| 本月下载数： | 48 次 |
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