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目的:临床药师通过对1例颅内胶质瘤术后化疗患者的药学服务,探讨临床药师如何对肿瘤患者进行药学监护。方法:临床药师以抗肿瘤药物的用法、药物相互作用、药物不良反应、出院用药指导等作为切入点,根据患者病情提出用药方案调整,给临床医师提出合理化治疗建议。结果:该患者在调整后的治疗方案中无严重不良反应发生,治疗效果满意。结论:临床药师的药学监护发挥了较重要的作用,保证患者用药安全有效。
OBJECTIVE: The clinical pharmacist, through a pharmacy service to patients with postoperative chemotherapy of intracranial glioma, discusses how clinical pharmacists can carry out pharmacy care for cancer patients. Methods: Clinical pharmacists used anticancer drugs, drug interactions, adverse drug reactions, medication guidance as the starting point, according to the patient’s condition proposed drug program adjustments to clinicians to put forward rational treatment recommendations. Results: The patient had no serious adverse reactions in the adjusted treatment plan, and the treatment effect was satisfactory. Conclusion: Pharmacokinetic monitoring of clinical pharmacists has played a more important role to ensure that patients are safe and effective.