临床药师参与1例替罗非班致极重度血小板减少症的病例分析

Clinical pharmacist participation in a case of extreme severe thrombocytopenia induced by tirofiban

目的:探讨替罗非班致极重度血小板减少症的临床特点、防治策略以及临床药师在其中发挥的作用。方法:查阅国内外文献,对1例替罗非班导致的极重度血小板减少症的病例进行分析。结果 :患者在应用替罗非班24 h内出现血小板计数严重下降,降至1.00×10^(9)/L,伴穿刺部位瘀斑出血,及时停用替罗非班后,血小板计数于停药后第5天恢复至正常范围内。结论 :应用替罗非班的1~24 h内应加强血小板监测以及出血情况监护。临床药师应协同临床医生关注使用此类药物的患者,对可能出现的风险进行严格监控。

Objective:To discuss the characteristics,prevention and treatment strategies of extremely severe thrombocytopenia induced by tirofiban,and the role of clinical pharmacists in it.Methods:By reviewing domestic and foreign literature,the case of extremely severe thrombocytopenia caused by tirofiban was analyzed.Results:Extremely severe thrombocytopenia occurred within the 24 hours after application of tirofiban and his platelet counts dropped to 1.00×10^(9)/L,accompanied by ecchymosis and bleeding at the puncture site.After tirofiban was stopped in time,the platelet count returned to normal range on the 5 th day after stopping the drug.Conclusion:The monitoring of platelet and bleeding should be strengthened within 1-24 hours after application of tirofiban.Clinical pharmacists should cooperate with clinicians to pay attention to patients using such drug and strictly monitor the possible risks.