经皮冠状动脉介入治疗术后亚急性支架内血栓形成并发肝功能异常患者的药学服务
投稿时间:2018-05-11  修订日期:2018-12-26  点此下载全文
引用本文:黄莹,孙力,范瑞.经皮冠状动脉介入治疗术后亚急性支架内血栓形成并发肝功能异常患者的药学服务[J].药学实践杂志,2019,37(2):183~187
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作者单位
黄莹 新疆第二师库尔勒医院药剂科, 新疆 库尔勒 841000 
孙力 新疆自治区人民医院药学部, 新疆临床药学研究所, 新疆 乌鲁木齐 830000 
范瑞 新疆第九师医院药剂科, 新疆 塔城 834600 
基金项目:全军后勤科研计划重大项目(AWS14L005)
中文摘要:目的 通过临床药师参与经皮冠状动脉介入治疗(PCI)术后亚急性支架内血栓形成并发肝功能异常患者的临床治疗和药学服务,探讨临床药师所起的作用。方法 临床药师通过分析患者PCI术后亚急性支架内血栓形成及发生肝功能异常的原因,根据患者病情、基因型、合并用药、相互作用、不良反应等,及时调整患者抗血小板治疗药物为替格瑞洛90 mg,po,bid,同时减少瑞舒伐他汀剂量为10 mg,po,qn,并行药学监护和用药教育。结果 医师采纳临床药师建议,患者病情好转。结论 临床药师应发挥自身专业所长,协助医师调整患者药物治疗方案,保证患者用药安全、有效。
中文关键词:心肌梗死  亚急性支架内血栓形成  肝功能异常  氯吡格雷  瑞舒伐他汀
 
Pharmaceutical care for a patient with subacute stent thrombosis complicated with liver-function abnormalities after PCI
Abstract:Objective To participate in the clinical treatment and pharmaceutical care for a patient with subacute stent thrombosis complicated with liver-function abnormalities after percutaneous coronary intervention(PCI)and to explore the role of clinical pharmacists in the treatment group.Methods Clinical pharmacists took an active part in the treatment process by analyzing the causes of subacute stent thrombosis and abnormal liver function after PCI.Pharmaceutical professional knowledge was used according to the patient's condition,genotype,combined medication,interaction,and adverse reaction and so on.The patient's antiplatelet therapy was timely adjusted to ticagrelor 90 mg po bid,and the dose of rosuvastatin was 10 mg po qn.Pharmaceutical care and medication education were also provided.Results The suggestions of clinical pharmacists were adopted by physicians and the patient was recovered.Conclusion Clinical pharmacists should use professional skill to assist physician to adjust the drug treatment program for patients,so as to guarantee the safe and effective of medicines use.
keywords:myocardial infarction  subacute stent thrombosis  liver-function abnormalities  clopidogrel  rosuvastatin
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