临床药师对感染性心内膜炎瓣膜置换术后合并急性肾衰竭患者的药学监护

Pharmaceutical care for one patient with infectious endocarditis complicated with acute renal failure after valve replacement

肾功能对抗感染治疗及抗凝治疗具有明显的影响。临床药师对1例感染性心内膜炎瓣膜置换术后合并急性肾衰竭患者进行药学监护。通过查阅文献,临床药师对抗感染治疗的药物选择、给药剂量、疗程及不良反应给出建议,重点监护抗凝治疗中出凝血情况和药物相互作用,密切监测肾功能变化、抗感染治疗和血小板对抗凝治疗的影响,保障临床用药安全有效。

The renal function has obvious influence on the anti-infection therapy and anticoagulation therapy. Clinical pharmacists provided pharmaceutical care for one patient with infective endocarditis complicated with acute renal failure after valve replacement. Through consulting the literature, clinical pharmacists gave suggestions on drug selection, dosage, course of treatment and adverse reactions in the anti-infection therapy. They focused on monitoring the coagulation in anticoagulation therapy and drug interaction, and closely monitored the changes in renal function, anti-infection therapy and platelet impact on anticoagulation therapy. Clinical pharmacists, help ensure the safety and efficacy of medication.