神经内科临床药师开展药学监护的案例分析和体会

目的 通过典型案例分析，为临床药师参与合理用药工作提供参考。方法 临床药师结合患者自身特点、药物相互作用、配伍禁忌、药品不良反应等，参与治疗方案的优化并对患者进行药学监护。结果 临床药师在神经内科开展药学服务，主要涉及脑血管、帕金森、脑炎等疾病的患者，运用药学专业知识，检索文献循证支持，参与治疗方案的制定，实现药物治疗个体化，提高患者依从性，减少不合理的用法用量、不适宜的联合用药以及药品遴选不当的发生，参与药品不良反应的处置，保障用药安全，促进合理用药。结论 临床药师开展药学服务需要运用自身扎实的业务知识以及良好的沟通能力，协助医生制定个体化的给药方案，保障药物治疗的安全、有效、经济。

Case study of pharmaceutical care provided by clinical pharmacists for the department of neurology

Objective To provide reference for clinical pharmacists to participate in rational drug use through case study.Methods Clinical pharmacists participated in the optimization of treatment plan and performed pharmaceutical care for the patients according to their own characteristics, drug interactions, compatibility contraindications and adverse drug reactions.Results Clinical pharmacists provided pharmaceutical care for the patients with cerebrovascular diseases, Parkinson''s disease, encephalitis and other diseases in the Department of Neurology by using pharmaceutical expertise, retrieved evidence-based support from literature and participating in the formulation of treatment plans. Those achieved individualized drug treatment, improve patient compliance, reduced the occurrence of unreasonable usage and dosage, inappropriate drug combination and improper drug selection, the treatment of adverse drug reactions, drug safety, and rational drug use.Conclusion Clinical pharmacists need to use their sound professional ability and good communication skills to help doctors make individualized drug delivery plans to ensure the safety, effectiveness and economy of drug treatment.