摘要
目的:探讨临床药师在NK/T细胞淋巴瘤(NK/TL)伴糖尿糖患者化疗过程中实施药学监护的模式、方法与作用。方法:临床药师参与1例NK/TL伴糖尿病患者的SMILE方案的化疗,在首次化疗时对化疗过程潜在的风险进行评估,并实施个体化用药监护并提出建议。具体为给予胰岛素注射液4 U,ivgtt控制地塞米松所致血糖值升高;给予碳酸氢钠40 ml,ivgtt,bid碱化尿液,别嘌醇0.1 g,po,tid抑制尿酸形成;给予补液4 000 ml/d预防肾功能衰竭,冲入美司钠0.4 g/次进行尿路保护;对可能出现的过敏反应和骨髓抑制进行监护;对SMILE方案的解救药物亚叶酸钙的使用进行用药教育。结果:医师采纳临床药师建议,患者化疗过程顺利,未出现药品不良反应,用药依从性良好。结论:临床药师参与患者化疗过程,对其潜在的风险进行评估并实施个体化用药监护,可优化患者的药物治疗方案,降低药物治疗过程中的风险,确保用药安全。
OBJECTIVE：To explore the mode,methods and role of clinical pharmacists providing pharmaceutical care for patients with natural killer/T-cell lymphoma（NK/TL） complicated with diabetes. METHODS：Clinical pharmacists participated in SMILE chemotherapy plan for a NK/TL patients with diabetes mellitus,evaluated potential chemotherapy risk during first chemotherapy,implemented individual medication monitoring and put forward suggestion. It included insulin injection 4 U,ivgtt,to control the increase of blood glucose induced by dexamethasone;sodium bicarbonate 40 ml,ivgtt,bid to alkalize urine;allopurinol0.1 g,po,tid to inhibit uric acid;fluid infusion 4 000 ml/d to prevent renal failure;mesna 0.4 g/time to protect urinary passage;monitorring potential allergic reaction and arrest of bone marrow;providing medication education on the application of calcium folinate in SMILE chemotherapy regimen. RESULTS：Physicians adopted the suggestions of clinical pharmacist,and chemotherapy was carried out smoothly. No ADR was found,and patients manifested good medication compliance. CONCLUSIONS：Clinical pharmacists participate in chemotherapy,evaluate potential risk and provide individual medication monitoring,which optimize therapy plan,reduce medication risk and guarantee the safety of drug use.
出处
《中国药房》
CAS
北大核心
2016年第5期700-702,共3页
China Pharmacy
关键词
NK/T细胞淋巴瘤
临床药师
药学监护
Natural killer/T-cell lymphoma
Clinical pharmacist
Pharmaceutical care
