1例合并附壁血栓的缺血性心肌病心衰患者的用药分析及药学服务

Medication analysis and pharmacy service for a patient with heart failure in ischemic cardiomyopathy combined with appendage thrombosis

本研究中临床药师参与了1例缺血性心肌病合并心衰患者的治疗过程,对患者既往病史及用药史进行了梳理,针对患者有过胃肠道出血史且目前处于慢性心衰急性加重失代偿期,对其抗栓治疗方案进行了分析,并对用药过程中血钾管理和他汀药物选择提出优化建议。记录患者每日查房病情发展情况,与医师沟通学习缺血性心肌病心衰患者治疗的经验知识,关注细节、对比联系,从用药有效性、安全性、患者依从性方面进行了密切关注,在药物比较选择、不良反应和用药教育等方面,为患者安全用药提供药学服务。

The clinical pharmacist plays a crucial role in managing a patient with ischaemic cardiomyopathy(ICM)and heart failure,conducting a thorough review of the patient’s medical and medication history.Notably,the patient had a history of gastrointestinal bleeding and was currently experiencing an acute exacerbation of chronic heart failure.An analysis of the patient’s antithrombotic regimen was performed,and recommendations were made to optimize potassium management and select an appropriate statin during the course of drug administration.We meticulously documented the patient’s daily check-ups,engaging in communication with physicians to acquire empirical knowledge regarding the treatment of heart failure patients with ICM.Furthermore,we diligently focused on details and established comparative links while closely monitoring the medication’s efficacy,safety,and patient compliance.This included a particular emphasis on comparative drug selection,identification,and management of adverse reactions,as well as medication education.Overall,our aim was to provide comprehensive pharmacy services to ensure the safe and effective use of medication by patients.