临床药师对1例肾移植术后排斥患者的药学服务

目的 以1例出现术后排斥的肾移植患者为例，探讨临床药师在肾移植受者术后排斥治疗中的药学监护要点。方法 临床药师参与1例肾移植术后发生排斥反应患者的治疗，从调整优化用药方案、关注药物的疗效及不良反应、注意药物的相互作用、以及提供患者用药教育等方面，实施全方位的药学监护。结果 患者肾功能有所好转，治疗期间临床药师提供全方位临床药学服务，完善及提高了临床药物治疗实施。结论 临床药师参与肾移植受者术后治疗团队，为患者制订个体化的药学监护，进行临床药学服务，可保证患者用药安全、有效。

Clinical Pharmacy Services for a Renal Transplant Recipient with Rejection Provided by Clinical Pharmacists

OBJECTIVE To investigate the method and experience of a clinical pharmacist participating in the pharmaceutical care of renal transplant recipients with rejection, using the case analysis of renal transplant recipient with postoperative rejection. METHODS The clinical pharmacists were involved in the treatment of a renal transplant recipient with rejection, and provided the clinical pharmacy services in the adjustment and optimization of medication regimen, monitoring adverse drug reactions, drug-drug interaction, providing medication education and other aspects. RESULTS Renal function of the patient was improved. During the treatment period, clinical pharmacists provided the comprehensive clinical pharmacy services to improve the implementation of medication therapy. CONCLUSION The clinical pharmacists participate in the post-operative treatment team of renal transplant recipients, and provide individualized pharmaceutical care and clinical pharmacy services, so as to ensure the safety and effective of medication therapy in patients.