心房颤动合并冠心病患者的药学监护

Pharmaceutical care of coronary heart disease with atrial fibrillation in one case

目的探讨心房颤动合并冠心病的药学监护点和规范化的药学监护模式。方法临床药师以1例心房颤动合并冠心病患者的用药为切入点,利用药物相互作用、不良反应等药学知识,参与药物治疗方案的选择,实施药学监护。结果与结论心房颤动合并冠心病患者往往用药较为复杂,临床药师应围绕患者的抗凝方案,关注药物的相互作用,监测药物不良反应,用药教育则应以华法林和冠心病二级预防为主。

Objective To explore the pharmaceutical care points and standardized model for patients with cardiac fibrillation and coronary disease. Methods The specific medication in one case of patient with cardiac fibrillation and coronary disease was regarded as a breakthrough point. Utilizing knowledge of drug inter- reactions and adverse drug reactions,clinical pharmacists participated in the decision of treatment regime and the performance of pharmaceutical care. Results and Conclusion Complex medication would be adopted for patients with cardiac fibrillation and coronary disease usually. Clinical pharmacists should focus on drug inter- reactions and monitor adverse drug reactions,as well as the anti- coagulant regimen. For pharmaceutical education,warfarin and the second grade of prevention of coronary disease would be primary.