OBJECTIVE:To probe into the effect of the participation of clinic pharmacists in the clinic research and provision of the pharmaceutical care service. METHODS:Pharmaceutical care was given to a case of patient with renal transplantation by the clinic pharmacists, which showed abnormal increase of blood concentration of cyclosporine in short term. Through analyzing the factors that affected the blood concentration including the medication compliance of the patient, the drug combination, the test method and the dietary circumstances, the results suggested that the guajave used by the patient was very likely to be the factor that affect the blood concentration of cyclosporine. RESULTS:According to the monitoring results of the blood concentration and other examination indicators, the dosage regimen had been gradually adjusted, and the patient's blood concentration of cyclosporine turned into the normal range. CONCLUSIONS:Pharmaceutical care conducted by the pharmacists plays an essential role in the treatment of the patient, which could help to find the factors that affect the efficacy of the drugs early and give timely intervention so as to guarantee the safety and effectiveness of the drug use for the patients.%目的:探讨临床药师深入临床、提供药学监护服务的作用. 方法:临床药师对1例肾移植患者进行药学监护,发现其近期环孢素血药浓度异常升高. 通过分析患者服药依从性、联合用药情况、实验操作方法以及饮食情况等影响因素,发现患者很有可能因为食用番石榴导致环孢素血药浓度升高. 结果:根据血药浓度监测结果及其他检查指标,逐步调整患者的给药方案后,患者的环孢素血液浓度恢复至正常范围. 结论:临床药师进行药学监护在患者的治疗过程中发挥着重要作用,可及早发现影响药物疗效的因素并及时干预,保障患者用药的安全性和有效性.
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