长期服用华法林抗凝患者的药学监护

Pharmaceutical care for patients using warfarin for long-term anticoagulation

目的探讨临床药师对长期服用华法林患者进行药学监护的内容和模式。方法以3例长期服用华法林的患者为例,分析服药期间出现不良事件的原因,总结临床药师在华法林抗凝治疗中需重点监护的内容。结果通过实施药学监护,临床药师发现对于长期服用华法林的患者,药学监护应重点关注以下几个方面对华法林抗凝作用的影响:(1)患者疾病状态;(2)合并使用药物的影响;(3)患者是否有外科手术或者创伤性检查;(4)患者饮食习惯。结论临床药师为华法林的监护模式提供了合理化建议,并对患者进行用药教育,从一定程度上保障了华法林在临床使用过程中安全合理和有效。

Objective To determine the content and pattern of pharmacy care for patients who used warfarin for long-term anticoagulation. Methods Three patients who used warfarin for long-term anticoagulation were taken as examples. The causes of adverse events were analyzed. The contents of pharmaceutical care provided by clinical pharmacists during warfarin anticoagulation were summarized. Results Clinical pharmacists found that in long-term warfarin treatment, pharmaceutical care of warfarin anticoagulation should focus on the following aspects： （1） patient disease status; （2） combination with other drugs; （3） whether patients had surgery or traumatic examination; and （4） patient diet. Conclusion Pharmacists provided reasonable suggestions for the monitor of warfarin use to ensure its safety and effectively.