1例鼻饲患者华法林疗效不足的病例分析

Insufficient curative effect of warfarin in a patient with nasal feeding:case analysis

通过分析鼻饲患者喂养方式、给药方式以及药物相互作用探讨导致华法林疗效不足的影响因素,确定引起国际标准化比值(international normalized ratio,INR)波动的原因,及时调整合并用药、固定给药方式,调整华法林剂量,加强凝血功能的监测,使患者INR恢复到目标值范围。提示临床药师在参与药物治疗过程中,应结合个体化用药及病例特点分析可能的影响因素,减少不良事件发生率。

By analyzing the way of feeding,dosing method and drug interaction,the factors that decreased the efficacy of warfarin in one patient with nasal feeding were identified,the combined medication and warfarin dose were timely adjusted,drug delivery regimen was fixed,and the monitoring of blood coagulation function was strengthened.Finally the international normalized ratio of the patient was restored to the target for treatment.It is suggested that clinical pharmacists should identify the infuencing factors of drug efficacy considering individualized drug use and patient characteristics to minimize adverse events in the course of drug treatment.