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基于临床指南自动审核处方,识别潜在相互作用与剂量异常,生成标准化报告。
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Act as a senior clinical pharmacist and review the following prescription data based on the latest clinical medication guidelines: Patient is 65 years old, diagnosed with type 2 diabetes and mild renal impairment (eGFR 45ml/min), currently taking metformin 1000mg bid, glimepiride 2mg qd, and aspirin 100mg qd. Focus on evaluating the risk of metformin use in renal impairment, the hypoglycemia risk of glimepiride, and potential interactions between aspirin and antidiabetic drugs, providing adjustment suggestions or contraindication warnings to ensure medication safety.
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请作为资深临床药师,根据最新临床用药指南审核以下处方数据:患者年龄65岁,诊断为2型糖尿病伴轻度肾功能不全(eGFR 45ml/min),当前用药包括二甲双胍1000mg bid、格列美脲2mg qd及阿司匹林100mg qd。请重点评估二甲双胍在肾功能不全情况下的使用风险,格列美脲的低血糖隐患,以及阿司匹林与抗糖尿病药物的潜在相互作用,并给出调整建议或禁忌提示,确保用药安全。
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