CAJ | 학술논문

1例70岁老年男性患者，因心力衰竭加重合并有高血压病和低钾血症入院治疗。给予强心、利尿、补钾、扩血管、抑制神经内分泌等对症治疗。住院期间临床药师对患者进行药学监护，主要包括利尿剂的选择、电解质紊乱的监护、重组人脑利钠肽及洋地黄类药物的合理应用，监测药品不良反应及患者肝肾功能等相关指标。并根据监护结果及时调整给药方案，同时对患者进行用药教育，以提高药物治疗效果。
1례70세노년남성환자，인심력쇠갈가중합병유고혈압병화저갑혈증입원치료。급여강심、이뇨、보갑、확혈관、억제신경내분비등대증치료。주원기간림상약사대환자진행약학감호，주요포괄이뇨제적선택、전해질문란적감호、중조인뇌리납태급양지황류약물적합리응용，감측약품불량반응급환자간신공능등상관지표。병근거감호결과급시조정급약방안，동시대환자진행용약교육，이제고약물치료효과。
One 70-year-old elderly male patient with hypertension and hypokalemia was hospitalized because of aggravation of heart failure. The patient was given symptomatic treatment, including strong heart, diuresis, potassium supplement, expanding blood vessel, inhibition of neuroendocrine and so on. Pharmaceutical care was given to the patient by clinical pharmacists, which mainly included selection of diuretics, monitoring electrolyte disturbances, rational use of recombinant human brain natriuretic peptide and digitalis, monitoring adverse drug reaction as well as hepatic and renal function of the patient. Clinical pharmacists gave recommendations on adjusting dosage regimen according to the monitoring results, and provided medication education to the patient for improving the therapeutic effect of drugs.