1例老年急性脑梗死患者合并多种并发症的药学监护

Pharmaceutical Care for a Case of Aged Acute Cerebral Infarction with Various Complications

目的:为老年脑梗死合并多种并发症的治疗及药学监护提供参考。方法:临床药师参与1例老年急性脑梗死合并消化道出血、肝功异常及肺部感染患者的治疗,为医师提供药物治疗信息、分析用药后的疗效及安全性,并根据药物的临床疗效及时调整用药方案。结果:临床药师利用药学专业知识,对患者的治疗方案进行全程的药学监护,协同医生进行药物治疗方案的决策保障了患者药物治疗的有效性和安全性。结论:脑梗死的发病率及并发症在老年人中较高,由于老年人生理功能减退等原因导致其用药存在较大的安全隐患,临床药师利用专业的药物知识在治疗团队中实施全过程的药学监护可提高临床治疗水平,促进合理用药。

Objective： To proeide reference for the pharmaceutical care for aged acute cerebral infarction with various complica- tions. Methods： Clinical pharmacists participated in the treatment for an elder patient with acute cerebral infarction complicated with gastrointestinal bleeding, liver dysfunction and pulmonary infection through providing drug therapy information, analyzing the effect and safety of drug therapy and adjusting the pharmaceutical care plan according to the drug efficacy in time. Results： Taking use of phar- maceutical knowledge, c]inical pharmacists provided whole-course pharmaceutical care for the treatment of the patient and coordinated with doctors to make the drug therapy, which guaranteed the effectiveness and safety of therapy. Conclusion： The old are with high in- cidence of cerebral infarction, and complications are common. Due to their physiological dysfunction and the other reasons, high safety risk exists in their drug therapy. Clinical pharmacists can use their professional knowledge to provide whole-course pharmaceutical care for the patients in order to improve the therapeutic effect and promote the rational drug use.