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耶氏肺孢子菌是一种机会性病原体,可在免疫低下患者中导致耶氏肺孢子菌肺炎(PCP),该病常见于人免疫缺陷病毒(HIV)感染的患者。近年来,随着免疫抑制药物的应用,耶氏肺孢子菌肺炎在HIV阴性患者中的发病率呈上升趋势[1]。与HIV感染者相比,非HIV感染者的PCP进展迅速,治愈需要依靠早期诊断,值得我们警惕[2-3]。本病例起病急,属于肾移植术后免疫力低下患者,临床容易漏诊,进行及时的治疗非常关键,因此,药师查阅相关文献,通过对PCP抗感染治疗方案进行用药分析,及时发现治疗过程中出现的不良反应,作出合理的处置,以更好地帮助临床在今后的工作中对PCP治疗用药的把控。
Pharmaceutical care in a case of patient with Pneumocystis jiroveci pneumonia after renal transplantation
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摘要:
目的 探讨临床药师在肾移植术后患者出现耶氏肺孢子菌肺炎感染时的个体化治疗和用药监护中的作用。 方法 临床药师参与1例肾移植术后耶氏肺孢子菌肺炎患者的药学实践过程,及时查阅文献,对其抗感染治疗方案进行用药分析并调整,及时发现治疗过程中出现的不良反应,作出相应的处置。 结果 临床药师协助医生调整药物治疗方案,患者经治疗后病情痊愈。 结论 临床药师充分了解相关的治疗指南,药物的有效性和安全性特点,协助临床发现药物治疗相关问题,有利于建立个体化治疗方案,提高患者用药的安全性和有效性。 Abstract:Objective To discuss the role of clinical pharmacist in individualized treatment and pharmaceutical care for a patient with Pneumocystis jiroveci pneumonia after renal transplantation. Methods The clinical pharmacist participated in the pharmaceutical care for a patient with Pneumocystis jiroveci pneumonia after renal transplantation. the literature were reviewed and analyzed and the medication of anti-infective treatment plan was adjusted by Clinical pharmacist. The adverse reactions in the treatment process were discovered in time, and corresponding treatments were made. Results Clinical pharmacists assisted physicians to adjust the medication plan and the patient recovered well after the treatment. Conclusion Clinical pharmacists could assist doctors in discovering drug treatment-related problems by mastering relevant treatment guidelines, the effectiveness and safety characteristics of drugs, which could help to establish individualized treatment plans and improve the safety and effectiveness of patients' medication. -
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