CAJ | 학술논문

临床药师对一例感染性心内膜炎合并肾功能不全患者进行全程药学监护，从分析疾病用药特点、评估并提供可选治疗方案以及选择药物剂量等方面为临床提供药学服务。临床药师的建议优化了治疗方案，保证了患者用药的安全有效。
림상약사대일례감염성심내막염합병신공능불전환자진행전정약학감호，종분석질병용약특점、평고병제공가선치료방안이급선택약물제량등방면위림상제공약학복무。림상약사적건의우화료치료방안，보증료환자용약적안전유효。
The whole pharmaceutical care package was given by clinical pharmacist to a patient with infective endocarditis and renal insufficiency .The pharmacist performed pharmaceutical care by analyzing the condition of the patient ,evaluating and making treat-ment plan and adjusting the drug dosage .With the cooperation of clinical pharmacist ,the doctor optimized the treatment plan to individ-ualize treatment ,and ensured the effectiveness and safety of medications .