CAJ | 학술논문

目的：探讨临床药师对肾移植术后的糖尿病患者实施药学监护的过程、方法及作用。方法：针对1例典型病例，临床药师在参与临床查房中发现治疗过程中存在的问题，从药物选择、用法与用量、药物相互作用、药品不良反应等方面进行用药干预和监护，并对患者开展用药教育，促进患者用药更有效、安全。结果与结论：医嘱审核和患者用药教育应是临床药师的基础工作，药师应熟练掌握专业知识及药品说明书、临床指南和专家共识，在专科化的同时，也要掌握其他常见疾病的临床特征和用药特点，与医师、护士沟通、协作，为合理用药提供保障。。
목적：탐토림상약사대신이식술후적당뇨병환자실시약학감호적과정、방법급작용。방법：침대1례전형병례，림상약사재삼여림상사방중발현치료과정중존재적문제，종약물선택、용법여용량、약물상호작용、약품불량반응등방면진행용약간예화감호，병대환자개전용약교육，촉진환자용약경유효、안전。결과여결론：의촉심핵화환자용약교육응시림상약사적기출공작，약사응숙련장악전업지식급약품설명서、림상지남화전가공식，재전과화적동시，야요장악기타상견질병적림상특정화용약특점，여의사、호사구통、협작，위합리용약제공보장。。
OBJECTIVE:To explore the process and approaches and role of clinical pharmacist in carryinng out pharmaceutical care for diabetic patient following undergoing renal transplantation .METHODS: During ward round , the clinical pharmacist detected the problems in the treatment process of one typical diabetic case following undergoing renal transplantation , then he carried out pharmacy intervention and pharmaceutical care from aspects of drug selection , usage&dosage , drug interaction , adverse drug reactions , and carried out patient education to promote safe and effective medication .RESULTS&CONCLUSIONS:Reviewing medical orders and providing medication education for patients are clinical pharmacists'basic job .It is important for pharmacists to have a good command of professional knowledge , drug package inserts , clinical guidelines and expert consensus , besides specialization , they also need to grasp the clinical features and drug use characteristics of the other common diseases , communicate and collaborate with physicians and nurses for guarantee of rational use of drugs .