临床药师参与1例心力衰竭、心肌梗死合并房颤患者的药物治疗

The Clinical Pharmacist Participated in the Drug Treatment of a Patient with Heart Failure,Myocardial Infarction and Atrial Fibrillation

目的梳理复杂治疗方案后的抗栓方案,重整抗栓药物和疗程,纠正不合理用药,促进合理用药。方法临床药师介入1例心力衰竭、多次因心肌梗死植入多枚支架,合并房颤,行射频消融和左心耳封堵患者的药物治疗,重整抗栓药物方案,并全程监控治疗药物,就不合理用药提出警示。结果患者明显好转,住院及出院随访期间未发生不良事件。结论临床药师的参与有助于精细化管理患者的药物治疗方案,并及时纠正不合理用药,更好的为患者服务。

OBJECTIVE The antithrombotic plan after the complex treatment plan was sorted out,the antithrombotic drugs and the course of treatment were reformed to correct irrational drug use and promote rational drug use.METHODS Clinical pharmacists were involved in a case of heart failure,implantation of multiple stents for myocardial infarction for many times,combined with atrial fibrillation,performed radiofrequency ablation and left atrial appendage occlusion,reformed the antithrombotic drug regimen,and monitored the treatment drugs throughout the whole process to warn against unreasonable drug use.RESULTS The patient improved significantly,and no adverse events occurred during hospitalization and discharge follow-up.CONCLUSION The participation of clinical pharmacists is helpful to fine management of drug treatment plan for patients,timely correction of unreasonable drug use,and better service for patients.