临床药师参与1例米托蒽醌致心力衰竭患者的药学监护

Analysis of the Adverse Reaction and Pharmaceutical Care of Clinical Pharmacists' for One Patient with Heart Failure Induced by Mitoxantrone

目的:为临床药师实施不良反应监测及其相关药学监护提供参考。方法:临床药师对1例急性非淋巴细胞白血病患者因使用米托蒽醌引起急性左心衰提出建议:停用米托蒽醌,给予硝酸异山梨酯片5 mg,po,tid+美托洛尔片12.5 mg,po,bid+呋塞米注射液20 mg,ivgtt,qd进行抗心衰治疗,减少患者静脉液体入量,并及时给予右丙亚胺、左卡尼汀等相关保护心脏药物,且针对该不良反应制定了有效的药学监护计划。结果:采用上述治疗方案1周后,患者胸闷、气短、呼吸困难等心衰症状明显改善。结论:临床药师重视药源性不良反应的观察分析及监护,积极为医师提供合理化用药建议,充分体现了不良反应监测及药学监护在临床治疗中的价值。

OBJECTIVE：To provide reference for the heart failure（HF） adverse reactions and pharmaceutical care. METHODS：Clinical pharmacists presented suggestions for the acute left HF of one patient with ANLL with the treatment of mitoxantrone：stopping mitoxantrone;given isosorbide dinitrate tablets 5 mg,po,tid and metoprolol tartrate tablets 12.5 mg,po,tid;furosemide injection 20 mg,ivgtt,qd and reducing the intravenous fluids intake and timely giving sexrazoxane,L-carnitine to promote rational drug use. RESULTS：According to the pharmaceutical care,the HF was significantly improved after one week. CONCLUSIONS：Clinical pharmacists should pay attention to the analysis and pharmaceutical care of drug-induced adverse reactions and provide suggestions for the rational drug use. It fully reflects the value of adverse reaction monitoring and pharmaceutical care in the clinical treatment.