对一例应用ARNI类药物治疗扩张型心肌病患者的药学服务

Pharmaceutical care of a patient with dilated cardiomyopathy using angiotensin receptor-neprilysin inhibitor drugs

目的:探讨临床药师对血管紧张素受体-脑啡肽酶抑制剂(angiotensin receptor-neprilysin inhibitor,ARNI)类药物应用于扩张型心肌病患者的药学服务要点。方法:临床药师对1例扩张型心肌病患者的抗心衰、抗感染治疗等方面实施药学服务。关注ARNI类药物的适应证、用法用量和药品不良反应(ADRs),并对患者进行用药教育和提供药学服务。结果:临床药师结合药物特点、ADRs、药物相互作用等,为医师调整药物治疗方案提供建议,并对患者实施药学服务。应用ARNI类药物期间,患者血压偏低,肾功能、血钾无异常,心衰症状得到明显控制。结论:临床药师为应用ARNI类药物的扩张型心肌病患者所提供的个体化药学服务可有效避免药物相互作用和ADRs,并提高治疗效果。

Objective:To explore the key points of pharmaceutical care for angiotensin receptor-neprilysin inhibitor(ARNI)drugs in patients with dilated cardiomyopathy by clinical pharmacists.Methods:The clinical pharmacists offered pharmaceutical care to a patient with dilated cardiomyopathy from the perspectives of heart failure and anti-infection.In the course of treatment,attention was paid to the indications,application,dosage and adverse drug reactions of ARNI drugs,and at the same time,medication education and pharmaceutical care were provided to the patient.Results:In accordance with the features of the drugs,adverse drug reactions and drug interactions,the clinical pharmacist provided valuable advice for the physicians to adjust treatment regimen,and offered pharmaceutical monitoring for the patient.In the application of ARNI drugs,the blood pressure of the patient was relatively low,with normal renal function and normal blood potassium level,and symptoms of heart failure were obviously controlled.Conclusion:Individualized pharmaceutical care by clinical pharmacists for the patient with dilated cardiomyopathy treated with ARNI drugs could effectively avoid drug interactions and adverse drug reactions,and more importantly could improve therapeutic effects.