1例心力衰竭患者的药物治疗及药学监护实践.pdfVIP

中国药物应用与监测 2014 年10月第11卷第5 期 Chinese Journal of Drug Application and Monitoring, Vol.11, No.5, October 2014 1 例心力衰竭患者的药物治疗及药学监护实践 1 2 1 1（1.吉林大学第一医院药学部，吉林 长春 130021 ；2. 珲春市医院临床药学室，吉林 珲春 李艳娇 ，郑明花 ，苗秋丽 ，宋燕青 133300 ） [摘要]　1例 70 岁老年男性患者，因心力衰竭加重合并有高血压病和低钾血症入院治疗。给予强心、利尿、补钾、扩血管、抑 制神经内分泌等对症治疗。住院期间临床药师对患者进行药学监护，主要包括利尿剂的选择、电解质紊乱的监护、重组人脑 利钠肽及洋地黄类药物的合理应用，监测药品不良反应及患者肝肾功能等相关指标。并根据监护结果及时调整给药方案，同 时对患者进行用药教育，以提高药物治疗效果。 [关键词]　临床药师；心力衰竭；重组人脑利钠肽；药学监护 [ 中图分类号]　R969.3　　 [ 文献标识码]　A　 [ 文章编号]　1672 – 8157(2014)05 – 0294 – 03 Pharmaceutical treatment and care on a patient with heart failure 1 2 1 1 LI Yan-jiao , ZHENG Ming-hua , MIAO Qiu-li , SONG Yan-qing (1. Pharmaceutical Department, the First Hospital of Jilin University, Changchun 130021, China; 2. Clinical Pharmacy Office, the Hospital of Huichun, Huichun 133300, China) [ABSTRACT]　One 70-year-old elderly male patient with hypertension and hypokalemia was hospitalized because of aggravation of heart failure. The patient was given symptomatic treatment, including strong heart, diuresis, potassium supplement, expanding blood vessel, inhibition of neuroendocrine and so on. Pharmaceutical care was given to the patient by clinical pharmacists, which mainly included selection of diuretics, monitoring electrolyte disturbances, rational use of recombinant human brain natriuretic peptide and digitalis, monitoring adverse drug reaction as well as hepatic and renal function of the patient. Clinical pharmacists gave recommendations on adjusting dosage regimen according to the monitoring results, and provided medication education to the patient for improving the therapeutic effect of drugs. [KEY WORDS]　Clinical pharmacist; Heart failure; Recombinant human brain natriuretic peptide; Pharmaceutical care 心力衰竭（heart failure ，HF ）是各种心血管疾病 气短10年，加重1个月”于2014 年1月4 日入院。该 发展的最后阶段，已成为世界范围内