1例替罗非班冠状动脉内给药致极重度血小板减少的药学监护

Pharmaceutical care for one case of acute serious thrombocytopenia caused by intracoronary administration of tirofiban

目的:探讨临床药师在替罗非班冠脉内给药致血小板减少进行药学监护中的作用。方法:临床药师参与1例替罗非班冠脉内给药致极重度血小板减少的药学监护,在患者出现血小板减少时,分析发生的原因及治疗方法,及时停用可疑药物替罗非班并建议输注血小板纠正。结果:医师采纳临床药师建议,停用药物并采取适当措施后,患者血小板计数逐渐恢复。结论:替罗非班冠脉内给药可引起血小板减少,临床药师参与药物治疗的过程中,能及时发现和处理药物不良反应,协助医师规范使用药物,从而更好地保障患者的用药安全。

Objective： To explore the role of clinical pharmacists in pharmaceutical care for acute profound thrombocytopenia caused by intracoronary administration of tirofiban. Methods： Clinical pharmacists engaged in the pharmaceutical care for a patient with acute serious thrombocytopenia induced by intracoronary administration of tirofiban. When the platelets reducing occured, we discussed possible causes and remedies for this phenomenon, and then suggested the physicians to stop using tirofiban but to give platelet transfusion instead. Results： Physicians adopted the suggestions of clinical pharmacists. The platelet count of the patient gradually recovered to normal level. Conclusion： Intracoronary administration of tirofiban can also cause thrombocytopenia. The participation of clinical pharmacists in the process of drug treatment can timely discover and deal with adverse drug reactions and assist physicians to use drugs rationally, which can further ensure medication safety of patients.