常见病用药指导答辩.docx

1、常见病用药指导答辩模块三常见疾病的合理用药指导及药学咨询服务一、实训目标1.能够对常见疾病进行判断,能够按照处方调配药品,并提供合理的用药指导及服药时的注意事项。2.能够对慢性病的康复给与科学用药指导,能够对长期服药导致的药物不良反应有必要的认识。3.能够根据患者的病情和特点,推荐相应的药品,并进行合理用药指导。4.能够自觉运用沟通技巧及药学服务礼仪,一切交流应符合职业道德标准。二、实训条件1.实训场地为社会药房,或有柜台和货架的模拟药店。2.按照药品摆放原则摆放的相关药品(数种数十种。3.实训人员两人一组,抽签决定扮演药师或购药者及咨询者。三、考核标准教师在成绩评定时,应用评分表进行实时评价

2、,评分表中的评分项目包括学员问病的过程中的仪表仪态、礼貌用语、职业道德、问病技巧和逻辑性、信息的准确性、沟通能力、诊断、药品介绍和用药指导等方面综合评定。四、实训项目一常见疾病病名和常用药患英语会话(一常见疾病双语病名(二常用药患英语会话Patient 患者I am thirsty (constipated.我渴(便秘了。I cough a lot.我咳嗽得厉害。I dont sleep well at night.我晚上睡不好。The wound is hurting.我的伤口疼。Pharmacist 药师Ill go and get you some cough mixture (a sl

3、eeping pill,a laxative,a tranquilizer,a pain-killer 我去给您拿点咳嗽药(安眠药,泻药,安定药,止疼药来。Patient 患者I only feel mild pain.I dont think a pain -killer is necessary.The pain is very severe.I cant stand it.Please give me a pain-killer at once.我只感到有轻微的疼痛,我想用不着吃止痛片。痛得很厉害。我简直受不了;请立即给我止痛片吧。感冒cold肺炎pneumonia 肝炎hepatiti

4、s 膀胱炎cystitis急性胃炎acute gastritis 胃炎gastritis 气管炎trachitis 支气管炎bronchitis 阑尾炎appendicitis 胃肠炎gastroenteritis 乳腺炎mastitis 肿瘤tumor 癌症cancer 流感influenza 白内障cataract 中风stroke冠心病coronary heart disease 糖尿病diabetes 肺癌lung cancer 肝癌liver cancer肺结核pulmonary tuberculosis 肝硬化hepatocirrhosis 慢性病chronic disease 肺

5、气肿emphysema 胃癌cancer of stomach 胃病stomach trouble 心脏病heart disease 高血压hypertensionTake one tablet of this pain-killer if you feel pain,but not more than once every four hours.假如您觉着疼就吃一片止痛片,但每次必须间隔四个小时。Patient患者How do I take these medicines?我怎样服这些药呢?Pharmacist药师One tablet,three times a day.一天三次,一次一片。

6、Two tablets,four times a day.一天四次,一次两片。two tablets at night.晚上服两片。One line(half linethree times a day.Shake it well before taking it.每天三次,每次一(半格。服前先摇匀。Please put it under your tongue,dont swallow it.把药放在舌头底下,不要往下咽。Please suck it.请含服。Please dissolve the pill in water before taking it.服前请将药丸放在水中溶化。One

7、 teaspoon three times a day.每天三次,每次一茶匙。Patient患者How do I use this suppsitory?我怎样用这栓剂?Pharmacist药师Inset one into your anus(vaginaevery night.每晚塞一个在肛门(阴道内。Patient患者Is this for internal use too?这也是内服药吗?Pharmacist药师This is for gargling only.这是含漱剂。This will loosen your stools.Please squeeze it into your

8、anus every night.这是通大便的。请每晚在肛门里挤一些。This is a special adhesive for easing the pain.Apply it to the painful area and change it every two day.这是专为止痛用的药膏。贴在痛处,两天换一次。Apply some of the ointment,and rub it into the skin.涂一些这种药膏并揉进皮肤里去。Paint this lotion to the itching spot with this small blush(cotton swab用

9、小刷子(棉花棍把洗剂涂在痒处。Please dissolve the tablet(powderin hot water.Soak your hand(footin it for twenty minutes twice a day.请将这药片(药粉溶化在热水里。将您的手(脚泡在里面,每日两次,每次20分钟。Patient患者How do I use these eye-drops and ointment?我怎样使用这些眼药水和眼药膏呢?Pharmacist药师Put the eye-drops into your right eye4-6times a day,each time one

10、to two drops.Squeeze a bit of the ointment on your eyelid every night.将这种眼药水滴入右眼,每天四至六次,每次一、两滴,每晚在眼皮里挤一点眼药膏。Patient患者How do I apply the nose drops?我怎样使用这滴鼻剂呢?Bend your head back as far as possible and then put them in.尽量把头向后仰,然后将药滴进去。Patient患者How do I apply the ear drops?我怎样使用滴耳剂呢?Pharmacist药师Turn y

11、our head to one side,put one to two drops in your ear.Press the tragus for a few seconds.将头歪向一侧,在耳朵里滴一、两滴药水,再把耳屏按几秒钟。Patient患者How do I take(makethe herb medicine?我怎样服(熬中药呢?Pharmacist药师Put herbs into a pot.Add about300c.c.of cold water.Simmer gently for20minutes.Drain the solution.The amount left wil

12、l be40to50ml,this is the first dose.Dont throw the dregs away.DO the same in the evening.That is the second dose.Take the first dose in the morning,the second in the evening.把草药放进锅内。加入300毫升冷水.用慢(文火煎20分钟。将药水滗出,约40-50毫升。这是头煎。不要将药扔掉。仍照原法下午再煎一次,这是二煎。头煎早晨服,二煎晚上服。We can make the solution for you for six d

13、ays.Take one bottle daily,half in the morning,and half in the evening. Please put them in the refrigerator or keep them in a very cool place.Dont take the medicine while it is cold.我们可以给您煎出六天的药。每天服一瓶上午半瓶,下午半瓶。瓶子要放在冰箱里或是放在凉爽的地方。但不要服用冷的药液。Patient患者Must I boil it before taking it?每次服用之前要将它煮开吗?Pharmacis

14、t药师No.Put it in a glass and warm it in a bowl of hot water.不必。可以将药盛在玻璃杯里,将它放在一碗热水中加温。Patient患者How do I take these big balls?这些大药丸儿怎么服呢?Pharmacist药师Chew and swallow the bits with water or put them in water to melt them.Remove the wax before taking it.把它掰成小块,嚼后用水咽下,或者把它泡在水里化开再喝。服前把蜡皮去掉。不必。可以将药盛在玻璃杯里,将

15、它放在一碗热水中加温。项目二急性上呼吸道感染(感冒的用药指导(双语【疾病概述】急性上呼吸道感染是鼻、鼻咽和咽喉部急性炎症的概称,俗称感冒,简称上感,主要由病毒所致,也可继发细菌感染。分类:1.普通感冒:普通感冒是一种常见病,是由于各种病毒引起的上呼吸道感染。当过度疲劳、受惊、淋雨、受寒时,存在于咽部、鼻部等处的病毒可迅速繁殖,释放毒素,引发鼻、咽、喉部的炎症。此时人体抵抗力下降,口腔中一般不危害人体的细菌会乘势繁殖,引起继发感染。一般不发热,少数可以出现37.237.3低热,全身症状为倦怠、肌肉酸痛、头痛、头晕等;鼻腔局部症状为流涕、鼻塞、喷嚏,咽部症状为咽干、咽痛、轻咳、无痰或有少量白色稀薄

16、痰。典型持续3天左右,一般7天内痊愈。2.流行性感冒:流行性感冒是由流感病毒引起的一种极易传染的呼吸道疾病。引起流行性感冒的病毒分甲、乙、丙三型,并有多种亚型,它是通过吸入空气中含病毒的小水滴,或通过接触流感患者污染的物品而受到传染。起病急骤、畏塞、高热(3839,咽痛、全身酸痛、乏力、鼻塞、打喷嚏、头痛。临床表现:本病表现多样,可有不同类型。年长儿症状较轻,婴幼儿则较重。常于受凉后1-3天出现发热、咳嗽、鼻塞、流清涕、咽部不适等症状。婴幼儿可突然出现高热、咳嗽、不想进食,可伴有呕吐、腹泻、烦躁,甚至惊厥。部分患儿发病早期出现脐周阵痛。体检可见咽部充血、扁桃体肿大等。婴幼儿常可并发引起中耳炎、

17、支气管炎、肺炎等。年长儿若患链球菌上感可引起急性肾炎、风湿热等疾病。治疗:1.治疗原则发病后应注意休息,多饮水,病毒感染者常以对症、中药及抗病毒药物治疗,细菌感染以抗菌药物治疗为主。2.对症治疗:(1降温及镇静高热可给予物理降温,如头部冷敷、35%酒精擦浴或温水擦浴,或口服阿司匹林每次5l0mg/kg,或口服扑热息痛每次1015mg/kg。高热烦躁者给退热剂的同时应给予苯巴比妥以防止惊厥的发生。(2鼻塞可在进食前或睡前用0.5%麻黄素滴鼻。用药前应先清除鼻腔分泌物,每次每侧鼻孔滴入12滴,可减轻鼻粘膜充血肿胀,使呼吸道通畅,便于呼吸和吮乳。3.抗病毒药物可防止病毒进入宿主细胞,抑制病毒核酸的复

18、制,干扰病毒蛋白质的合成,从而有可能抑制病毒在细胞内的繁殖,达到防治的目的。4.抗感冒复方制剂分类抗感冒复方制剂品种虽多,但从所含主要成分来看,常用的药物主要为抗过敏药,减轻鼻粘膜充血水肿药,解热镇痛药三大类。抗过敏药常选氯苯那敏(扑尔敏。减轻鼻粘膜充血的药常选伪麻黄碱。用这二种类型的药主要为减缓感冒的卡他症状。伪麻黄碱可减轻鼻塞、流涕而没有刺激心脏引起心悸和收缩外周血管引起血压升高的不良反应,扑尔敏与伪麻黄碱对减轻卡他症状有协同作用。解热镇痛药常选用对乙酰氨基酚、阿斯匹林。由于感冒的主要症状之一是头痛、发热、选用这类药以对症治疗。复方感冒药的成分中还有镇咳药和抗病毒药。镇咳药常选用中枢性镇咳

19、药右美沙芬,它有较好的镇咳作用。抗病毒药多数处方选用金刚烷胺,它对甲型流感病毒有一定作用,但因病毒变异,其疗效不肯定,同时金刚烷胺还有一定的副作用。所以一般情况不用。5.中医疗法上呼吸道感染在中医称伤风感冒,根据临床辩证分为风寒感冒和风热感冒,前者宜辛温解表,常用杏苏散或荆防败毒散。后者宜辛凉解表,清热解毒,常用银翘散加减或桑菊饮。【模拟情景对话】药师:您好!请问我能帮助您什么?Pharmacist:Hello,what can I do for you?顾客:我想来买感冒药。Customer:I want to buy some medicine for my cold.药师:请问您有哪些不

20、舒服的症状?Pharmacist:What symptoms do you have when you feel bad?顾客:我有点鼻塞,这几天不停地打喷嚏。Customer:Im a bit stuffy nose,and I cant help sneezing these days.药师:您这些症状持续了多长时间?Pharmacist:How long did your symptoms last?顾客:从前天开始。Customer:From the day before yesterday.药师:会不会流鼻涕?Pharmacist:Do you have any nose runni

21、ng?顾客:会啊,总是会有水一样的鼻涕流出来。Customer:Yes.The watery snot is always running.药师:您有没有头痛,全身酸痛或肌肉酸痛的现象?Pharmacist:Do you have any headache,ache of whole body or pain of the muscles?顾客:有点,还感觉头有点不适。Customer:Yes,a little bit.And my head feels uncomfortable.药师:有没有发热的现象?Pharmacist:Are you in a fever?顾客:没有。Customer

22、:No药师:咽喉痛不痛?有没有口渴?Pharmacist:Do you have a sore throat?And are you thirsty?顾客:咽喉不痛,也不是特别口渴。Customer:No药师:有没有咳嗽?Pharmacist:Do you cough?顾客:有点。Customer:A little bit.药师:咳嗽时有没有咳痰现象?Pharmacist:Do you have phlegm when coughing?顾客:有些,不是很多。Customer:Yes,not too much.药师:痰呈什么颜色?稀的还是稠的?Pharmacist:What color is

23、it?Thin or thick?顾客:白色,不稠。Customer:White,and thin.药师:您这两天吃饭怎么样?有没有恶心、呕吐?Pharmacist:How about eating these two days?Do you have nausea and vomit?顾客:感冒了,肯定胃口不好哦。Customer:I have no appetite when I catch a cold.药师:您在此之前没有受过凉?Pharmacist:Did you catch a chill before?顾客:嗯,有过,前几天,由于回宿舍晚了,没了热水,洗了个冷水澡,第二天起来就这

24、样了。Customer:Yes.Just the other day.Because I got back the dormitory late and there was no hot water,I had a cold bath.Then the second day I got the cold.药师:您除了有感冒症状外,还有没有其它什么不舒服的?Pharmacist:Do you feel bad besides the cold symptoms?顾客:没有。Customer:No药师:您自己服用过什么药吗?Pharmacist:Did you take any medicine?

25、顾客:用过维C银翘片,但是没一点用。Customer:Just Vitamin C Yin qiao Tablet,but It is no use.药师:哦,您有没有什么药物过敏?Pharmacist:Are you allergic to any medication?顾客:没有。Customer:No药师:您没有其它疾病?如胃病?Pharmacist:Do you have any other illness?Such as stomach trouble?顾客:也没有。Customer:No药师:从您的症状来看,您这是一个普通的感冒,属于风寒感冒型,您服用的维C银翘片是治疗风热型感冒,

26、所以服用这个药效果不好,请您到这边来,(把购药者带到普通感冒相应的柜台前并介绍药物,我给您介绍几种治疗风寒感冒的中成药:您可以选用风寒感冒冲剂,其主要成分是麻黄、葛根、防风等,具有疏风散寒发汗作用,可治疗风寒感冒,缓解鼻塞、流涕、打喷嚏的现象,温开水冲服、一次1袋,一日3次;您也可以服用荆防冲剂,这个药与风寒感冒冲剂治疗作用类似。您在服用这药之前仔细阅读说明书;此外,在服药期间,您需要多喝白开水,注意保暖。Pharmacist:From your symptoms,it is the common cold,the Feng han one.But the Vitamin C Yin qiao

27、 Tablet is in the treating of the Feng re cold.So this tablet does not act well.Please come over here.(Take the buyer to the counter for the common cold,and introduce the medicine.I introduce some Chinese traditional medicines for the Feng han cold to you.You can choose Feng han cold Instant Granule

28、s,which principle ingredients include the Ma huang,Ge gen and Fang feng,etc.All of these expel the wind,dispel cold and produce the perspiration in order to treat of the cold,as well as decrease the stuffy nose,the running nose and the sneeze.You will take one bag with warm water, three times a day.

29、On the other hand,you can take Jing fang Instant Granules,which effect is the same with the Feng han Cold Instant Granules.You should read the instructions before you take it.In addition,you should drink more boiled water and keep warm during taking this medicine.顾客:我想买些西药来吃,西药治疗更快。Customer:I want t

30、o buy some western medicine,which is much better.药师:西药,您可以选用复方药,我给您推荐新康泰克,它具有减轻感冒引起的鼻塞、流涕、打喷嚏症状;口服,一天2粒,早晚各一粒。Pharmacist:Western medicines you can choose.I recommend ContacNT,which can relieve the symptoms of the stuffy nose,the running nose and the sneeze.Take orally,twice a day,each a pill.顾客:那其有没

31、有什么不良反应?Customer:Does it have a bad reaction?药师:服用新康泰克的过程中,容易引起困倦、口干、胃不舒服、乏力、头晕、大便干燥等轻微的不良反应,所以每天的服药量不要超过2粒,服用的时间别超过3-7天。感冒症状消失之后就要停止用药。用药期间记得多喝水,如症状加重,请及时就医。Pharmacist:The minor adverse reactions,including sleepiness,thirsty,gastrointestinal troubles,tiredness, dizziness and constipation may occur during taking ContacNT.So,the dosage isnt taken over2pills each day,and the time isnt beyond3-7days.The medicine is ceased as soon as the cold symptoms disappear.Remember to drink more water during taking this medicine.If you feel worse,please go to the hospital as soo