摘要
目的:探讨临床药师在预防及处理索他洛尔致心力衰竭高龄患者QT间期延长中的作用。方法:临床药师参与1例心力衰竭高龄患者的药物治疗,协助医师识别并评估索他洛尔致QT间期延长的风险,根据患者临床症状和实验室检查指标先后建议继续使用索他洛尔抗心律失常,调整护肝药物的应用,并行心电监护、电解质水平监测及用药教育等药学监护。结果:医师采纳临床药师建议,患者病情好转,未出现恶性心律失常,11 d后出院。结论:心力衰竭高危患者的药物治疗应以改善心功能、维持血流动力学的稳定为主;临床药师可结合相关指南和文献,协助医师及时识别致QT间期延长的药物,评估发生尖端扭转型室性心动过速等不良后果的风险,共同制订和优化用药方案,加强药学监护,以保证治疗的安全、有效。
OBJECTIVE：To explore the role of clinical pharmacists participating in the prevention and treatment of sotalol-induced QT prolongation in aged patient with heart failure. METHODS：Clinical pharmacists participated in the treatment for a aged patient with heart failure,and assisted physicians to identify and assess the risk of sotalol-induced QT prolongation. According to the clinical symptoms and laboratory indexes,it was suggested to continue to use sotalol for antiarrhythmic,adjust the hepatoprotective drug,given pharmaceutical care of ECG,electrolyte level monitoring,drug education and so on. RESULTS：Physicians adopted the suggestions of clinical pharmacists to relive the illness without malignant arrhythmia and discharged after 11 d. CONCLUSIONS：The patient with heart failure should be dominated by improving cardiac function and maintaining hemodynamic stability;combined with related guidelines and documentation,clinical pharmacists can assist physicians to identify the drug that induced QT prolongation,asses the risk of torsades de pointes ventricular tachycardia and other bad consequences,develop and optimize the regimen and strengthen pharmaceutical care to ensure the safe and effective treatment.
出处
《中国药房》
CAS
北大核心
2016年第23期3284-3287,共4页
China Pharmacy
基金
重庆市医学科研计划项目(No.2013-1-057)
