1例房间隔缺损并肺动脉高压患者术后的药学监护

Post-operative pharmaceutical care on a patient with pulmonary arterial hypertension and atrial septal defect

1例23岁女性患者,因"发现房间隔缺损7个月"收入院,诊断为先天性心脏病,房间隔缺损,肺动脉高压(中-重度),行房间隔缺损修补术。术后为维持血流动力学相对稳定,需要用到镇静止痛药、肌肉松弛药、强心利尿药以及多种肺动脉高压靶向制剂。药物种类较多,且呈现不同药代动力学特点。临床药师查阅相关资料,挖掘每个药物的监护点,警惕可能存在的药物相互作用,提出合理用药的建议,保障临床用药安全有效。经积极治疗,最终患者病情稳定出院。

A 23-year-old female patient was admitted to the hospital for finding atrial septal defect 7 months ago. After admission, the patient was diagnosed as congenital heart disease, atrial septal defect, pulmonary hypertension(moderate to severe), and underwent repair of atrial septal defect. In order to maintain the relative stability of hemodynamics after operation, many kinds of drugs with different pharmacokinetic characteristics including sedatives, analgesics, muscle relaxants, cardiotonics, diuretics, and a variety of targeting agents for pulmonary hypertension were needed. Clinical pharmacists consulted the relevant information, focused on the key points of pharmaceutical care of each drug, kept alert to the potential drug interactions, and put forward suggestions for rational drug use, thus to ensure the safety and effectiveness of clinical drug use. After active efforts of the medical team, the patient was discharged with the stable condition.