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根据国际疼痛研究学会(International Association for the Study of Pain,IASP)对疼痛的定义,疼痛是伴随真实或潜在性组织损伤或者根据这种损伤所描述的不愉快的感觉和情感体验[1]。疼痛也是恶性肿瘤的最常见的并发症之一,尤其是在癌症晚期,约有70%的癌症患者会并发疼痛症状,癌症疼痛极为剧烈,严重影响患者的心理与生理,降低其生活质量和生存期[2-3]。目前,阿片受体激动剂吗啡仍是中重度癌痛的一线治疗药物,合成的长效阿片受体激动剂(如羟考酮缓释片)得到越来越广泛的应用。然而,人体对阿片类药物的敏感度个体差异较大,且缺乏剂量标准。众所周知,长期使用阿片类药物有易成瘾性等特点,不当使用易给患者带来严重不良反应[4-5],如呼吸抑制、便秘、皮肤瘙痒等。
现对1例转移性乳腺癌术后伴癌痛患者的用药治疗过程中,药师对患者的治疗用药进行分析,及时和医师沟通,并对此癌痛患者的治疗进行了用药干预、药学监护及用药健康教育,保证患者的合理用药。
Pharmaceutical care for a patient with cancer pain after surgery for metastatic breast cancer
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摘要:
目的 通过参与1例癌症疼痛患者的药物治疗和药学监护过程,临床药师参与制订药物治疗方案,并提出合理化用药建议,同时对患者进行健康教育,以减少或避免药物不良反应的发生。 方法 药师通过参与审方、发现问题,对不当处方及时干预,与医生沟通、更改用药方案,对患者进行健康教育等方式,参与患者的药学监护过程。 结果 在药师的干预下,医生更改用药方案,患者接受健康教育,并正确用药,成功地避免了不良反应的发生。 结论 药师通过参与1例转移性乳腺癌术后癌痛患者的药物治疗不当处方的干预,给予患者全方位药学监护,体现了药师在药学监护中的地位和重要性。 Abstract:Objective By participating in the process of drug treatment and pharmaceutical monitoring for a patient with cancer pain, clinical pharmacists participated in formulating drug treatment plans and proposed rational medication recommendations. At the same time, patients were given health education to reduce or avoid adverse drug reactions. Methods Pharmacists participate in the process of pharmacy monitoring of patients by participating in the review of prescriptions, discovering problems, intervening in time for improper prescriptions, communicating with doctors, changing medication plans, and providing health education to patients. Results Physicians accepted the suggestions of pharmacists and modified the medication regimen. The patient's condition improved. Conclusion The pharmacist participated in the intervention of an improperly prescribed medication for a patient with metastatic breast cancer postoperative cancer pain, and gave the patient a full range of pharmaceutical care, which reflects the importance of the pharmacist in pharmaceutical care. -
Key words:
- pain /
- analgesics /
- pharmacist /
- pharmaceutical care
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