CAJ | 학술논문

目的：：为肾移植术后肺部感染患者实施药学监护提供思路。方法：临床药师全程参与1例肾移植术后并发肺部感染患者的诊疗经过，通过查阅文献，结合患者病情，充分考虑患者病史、临床症状和实验室检查，对该患者药物治疗过程进行分析，并总结其治疗过程中的药学监护重点。结果：对该例肾移植术后肺部感染患者监护重点包括发病早期和病情好转时免疫抑制药剂量调整；多种抗感染药物与免疫抑制药合用时的药物相互作用；根据患者肾功能对患者用药剂量进行调整；药物不良反应监测等方面，为患者制定个体化用药方案。结论：临床药师通过全面的药学监护，能协助医师及时、有效地制定用药方案，为患者提供专业、有效的药学服务。
목적：：위신이식술후폐부감염환자실시약학감호제공사로。방법：림상약사전정삼여1례신이식술후병발폐부감염환자적진료경과，통과사열문헌，결합환자병정，충분고필환자병사、림상증상화실험실검사，대해환자약물치료과정진행분석，병총결기치료과정중적약학감호중점。결과：대해례신이식술후폐부감염환자감호중점포괄발병조기화병정호전시면역억제약제량조정；다충항감염약물여면역억제약합용시적약물상호작용；근거환자신공능대환자용약제량진행조정；약물불량반응감측등방면，위환자제정개체화용약방안。결론：림상약사통과전면적약학감호，능협조의사급시、유효지제정용약방안，위환자제공전업、유효적약학복무。
Objective:To provide some thoughts for pharmaceutical treatment and care for the patients with pulmonary infection af-ter renal transplantation. Methods:Clinical pharmacists participated the whole treatment process of one case of pulmonary infection af-ter renal transplantation. According to the literatures combined with medical history, clinical symptoms and lab results, the drug treat-ment process of the patient was analyzed, and the key points of the optimized pharmaceutical care were summarized. Results: The pharmaceutical care included the dose adjustment of immunosuppressants at the early phase of the disease and after the improvement of clinical symptoms, attention paid to the interactions between multiple anti-infective drugs and immunosuppressive agents, dosage ad-justment based on the renal function of the patient, monitoring adverse drug reactions and drawing up personalized regimen. Conclu-sion:Through comprehensive medication monitoring, clinical pharmacists can help physicians develop timely and effective treatment programs and provide professional and effective pharmaceutical care for patients.