目的 探讨临床药师在难治性药源性复发性口腔溃疡诊治中的作用.方法 临床药师通过参与3例难治性复发性口腔溃疡的诊治,根据药学相关知识及查阅相关文献,结合患者疾病状态及经济承受能力,及时判断为药源性口腔溃疡,并筛查出可疑药物及停药顺序,停药后严密随访监测患者停药反应.结果 3例复发性口腔溃疡患者溃疡持续发作1年多,临床药师利用药学专业知识判断其溃疡分别由硝苯地平控释片、苯磺酸氨氯地平和硫酸氢氯吡格雷导致,建议医生停药,停药后3例患者分别于第3天、第5天和第7天溃疡出现明显缓解,约10 d溃疡均愈合,至随访撰写本文,3例口腔溃疡均未复发,随访最长1年、最短1个月.结论 临床药师要充分发挥自己药学专业的优势及高度职业敏感性,在临床工作中及时辨别药源性疾病,协助临床医生更好地使用药物,保障患者用药安全.%Objective To explore the role of clinical pharmacists in the diagnosis and treatment of difficult drug-induced recurrent oral ulcers.Methods Clinical pharmacists,by participating in the diagnosis and treatment of 3 cases of difficult drug-induced recurrent oral ulcers,according to pharmacy-related knowledge and reading literatures in time,combined with the patient's disease starus and affordability,determined the cases to be drug-induced oral ulcers and screened out suspicious drugs and drug withdrawal order,and performed the close monitoring of patients for withdrawal reactions.Results The 3 patients with recurrent oral ulcers had ulcer for more than a year;finally clinical pharmacists,based on their pharmaceutical expertise,determined that nifedipine controlled release tablets,amlodipine besylate and clopidogrel hydrogen sulfate led to the ulcer and proposed withdrawal of the drugs;after stopping drugs the three patients soon were relieved,respectively in the first 3 days,5 days and 7 days,and about 10 days later ulcers healed.There was no relapse up to now.The follow-up lasted for one year as the longest period,the shortest,1 month.Conclusion Clinical pharmacists should give full play to their own professional advantages and a high degree of occupational sensitivity in clinical work in a timely manner to identify drug-induced diseases,in order to help clinicians better use of drugs to protect patients drug safety.
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