中国药师
中國藥師
중국약사
CHINA PHARMACIST
2015年
1期
105-107,108
,共4页
华法林%国际标准化比值%房颤%冠心病%药学监护
華法林%國際標準化比值%房顫%冠心病%藥學鑑護
화법림%국제표준화비치%방전%관심병%약학감호
Warfarin%INR%Atrial fibrillation%Coronary artery disease%Pharmaceutical care
目的：：探讨临床药师在房颤合并多种疾病的老年患者中开展华法林药学监护的内容和模式。方法：通过1例房颤合并冠心病、尿路感染的老年患者使用华法林后INR异常升高的病例，介绍临床药师分析导致INR异常升高的原因、协助医生制定个体化药学监护计划并实施全程药学监护的过程。结果：经过调整华法林剂量以及其他治疗药物、对患者进行用药教育，患者住院期间未发生出血及栓塞事件，最终达到满意的抗凝治疗效果。结论：对合并多种疾病的房颤患者实施抗凝方案的用药监护，有利于提高患者用药依从性，避免药物不良反应发生，更好地保障用药的有效性和安全性。
目的：：探討臨床藥師在房顫閤併多種疾病的老年患者中開展華法林藥學鑑護的內容和模式。方法：通過1例房顫閤併冠心病、尿路感染的老年患者使用華法林後INR異常升高的病例，介紹臨床藥師分析導緻INR異常升高的原因、協助醫生製定箇體化藥學鑑護計劃併實施全程藥學鑑護的過程。結果：經過調整華法林劑量以及其他治療藥物、對患者進行用藥教育，患者住院期間未髮生齣血及栓塞事件，最終達到滿意的抗凝治療效果。結論：對閤併多種疾病的房顫患者實施抗凝方案的用藥鑑護，有利于提高患者用藥依從性，避免藥物不良反應髮生，更好地保障用藥的有效性和安全性。
목적：：탐토림상약사재방전합병다충질병적노년환자중개전화법림약학감호적내용화모식。방법：통과1례방전합병관심병、뇨로감염적노년환자사용화법림후INR이상승고적병례，개소림상약사분석도치INR이상승고적원인、협조의생제정개체화약학감호계화병실시전정약학감호적과정。결과：경과조정화법림제량이급기타치료약물、대환자진행용약교육，환자주원기간미발생출혈급전새사건，최종체도만의적항응치료효과。결론：대합병다충질병적방전환자실시항응방안적용약감호，유리우제고환자용약의종성，피면약물불량반응발생，경호지보장용약적유효성화안전성。
Objective:To explore the content and model for clinical pharmacists to carry out pharmaceutical care on elderly pa-tients with atrial fibrillation combined with other diseases treated by warfarin. Methods:One case of an elderly atrial fibrillation patient complicated with coronary artery disease and urinary tract infection suffering elevated INR after the use of warfarin was applied as the example. The pharmaceutical care was carried out by clinical pharmacists including analyzing the causes of elevated INR and assisting the doctor to develop the individualized pharmaceutical care plan. Results: After the adjustment of warfarin dose and the other drugs combined with medical education, bleeding and thromboembolic events did not occur during the hospitalization, and finally, satisfactory effect of anticoagulation therapy was achieved. Conclusion: The implementation of pharmaceutical care on anticoagulation in atrial fi-brillation patients with various diseases is helpful to improve the compliance in patients, avoid the occurrence of adverse drug reactions and guarantee the effectiveness and safety of warfarin.
