目的：研究临床药师对肾内科患者抗菌药物选用的药学服务。方法选取我院肾内科2例患者对抗菌药物的选用进行药学服务，从药师对药物的选择、药物用量、出现不良反应的症状等方面进行观察。病例1患者由药师选择头孢哌酮舒巴坦、美洛培南等药物进对患者进行治疗；病例2患者药师给予氨曲南、法莫替丁、碳酸氢钠片、胃舒平片等药物进行治疗。并根据患者病情变化临床药师的经验选择用药时间。结果2例患者经临床医师的用药指导后，未出现明显的不良反应症状，药效有效的得到发挥，提高了患者药物的依从性。病例1患者用药后临床症状基本消失，血压也得到有效控制。病例2患者临床症状基本好转，中性粒细胞、白细胞、血清生物化验指标均比治疗前明显改善(P＜0.05）。结论对我院2例肾内科患者给予有效的药学服务，通过临床药师对肾内科患者进行抗菌药物的选择，用药方法指导、药物剂量及发生的不良反应症状给予分析，促使药物药效充分发挥，保证患者用药的安全、有效，减少病发症的产生。%Objective To study the clinical pharmacists of antimicrobial drug use in patients with renal medicine pharmaceutical care. Methods To choose the hospital urology department 2 patients to pharmaceutical care, the selection of antimicrobial agents from pharmacist's choice of drug, drug dosage, aspects and so on symptoms of adverse reactions were observed. Case 1 patients chosen by pharmacists cefoperazone shuba, and beauty from the south and other drugs in treating patients. The pharmacist to give 2 cases ammonia Aztreonam, famotidine, sodium bicarbonate, gastropin pieces and drug treatment. And according to the experience of the patient condition changes of clinical pharmacists to choose medication time. Results 2 cases patients after clinical physicians guidelines, without obvious adverse reaction symptoms, efficacy and effective work, improve the compliance of patients with drugs. Case 1 in patients with clinical symptoms disappeared basically, the medicine blood pressure under control. Basic cases of 2 patients with clinical symptoms improve, neutrophils, white blood cells, serum biological assay indexes were obviously improved than before treatment (P<0.05). Conclusion A total of 2 patients with renal medicine to give effective pharmaceutical care, by clinical pharmacists for the choice of antimicrobial agents in patients with renal medicine, use medicine guidance, doses of drugs and analyze the adverse reactions of symptoms occurring, prompting the drug efficacy into full play, to ensure the safe and effective for treating patients, reduce the disease onset of illness.
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