临床药师参与服用双联抗血小板药物患者行结肠息肉切除术的药学监护

Pharmaceutical care for polypectomy in a patient using dual antiplatelt therapy (DAPT) after percutaneous coronary intervention

目的 :探讨临床药师如何对服用双联抗血小板药物患者实施结肠息肉切除术时方案的制定与用药监护中的工作要点。方法 :1例经皮冠状动脉介入治疗术后规律服用阿司匹林、氯吡格雷的冠心病患者,现需进行结肠息肉切除术,临床药师根据患者的疾病特点和相关指南推荐,协助临床医师参与了其术前、术后抗血小板用药方案的制定与用药监护,保证了患者用药合理、安全、有效。结果 :确定符合患者病情的用药方案,制定了个体化的给药方案。结论:双联抗血小板药物患者实施结肠息肉切除术后参与和制定药物个体化方案,是临床药师开展药学服务工作的切入点。

Objective： To formulate the medication plan and implement individualized pharmaceutical care to the patient who would take polypectomy and use dual antiplatelt therapy（DAPT） after percutaneous coronary intervention（PCI）. Methods： The clinical pharmacists took reasonable selection of drugs in the patient who would take polypectomy and use DAPT after PCI. In the teratment, the clinical pharmacists adjusted thetreatment plan to assist doctors based on the characteristics of the patient and related guidelines. They carried out full-course pharmaceutical care, discovered and solved problems to ensure the rationality, safety, and effectiveness of medication. Results： The anticoagulant intensity was determined according to the characteristics of the patients in order to ensure the rationality, safety, and effectiveness of medication. Conclusions： The formulation of individualized programs of the patients who would take polypectomy and use dual antiplatelt therapy after percutaneous coronary intervention are the breakthrough point for the development of pharmaceutical care for clinical pharmacists.