Abstract: 【Abstract】〓Pharmaceutical care was performed for a patient with severe acute pancreatitis by clinical pharmacists, participating in the patient's diagnosis and treatment. Pharmacist gave the suggestions, which were concerned with adjusting esomeprazole sodium frequency(once a day), solvent (normal saline), keeping the dose of esomeprazole through CRRT and prolonging meropenem drip time to 3 hours. Pharmacist suggested doctors pay attention to ADR (adverse drug reactions),tigecycline-relevant pancreatitis, gastric retention of EN, and also got the fact of octreotide influence on blood sugar.

Key words: Severe acute pancreatitis, Clinical pharmacists, Pharmaceutical care　

摘要： 【摘要】〓药师参与1例急性重症胰腺炎的药学监护,发现以及解决的问题包括给予调整埃索美拉唑用药频次(qd给药)、生理盐水作为溶媒、CRRT-连续性肾脏替代治不必调整剂量、延长美罗培南输注时间(T=3 h)以及避开CTTR对药物的清除,旨在提高药物的治疗效果和减轻患者的经济负担等药学建议。另外,强调关注替加环素相关性胰腺炎风险的发生,生长抑素奥曲肽对血糖的影响以及患者肠内营养胃潴留的情况,减少药物不良反应(ADR)的发生率。

关键词: 重症急性胰腺炎, 临床药师, 药学监护