CAJ | 학술논문

目的：探讨一例2型糖尿病合并高血压病、肾功能不全患者入院后血肌酐变化的药物影响因素，并提出预防措施。方法：临床药师通过结合病历，查阅文献资料，对1例2型糖尿病合并高血压病、肾功能不全患者入院后血肌酐变化的药物因素进行评价、分析并干预。结合患者并发的基础疾病和使用的药物，提出药学建议，制定日后同类风险预防措施，提供药学服务。结果：该患者入院诊断为2型糖尿病，合并高血压病、肾功能不全等基础疾病，同时院内使用过培哚普利、奥美沙坦酯、托拉塞米、二甲双胍、碘普罗胺造影剂等存在肾损害或诱发肾损害的药物，是患者血肌酐升高的重要因素。结论：临床药师在诊疗活动中及时、准确地发现与药物相关的不良事件，评估风险，提出优化的治疗方案，可保证药物治疗的安全性和有效性。
목적：탐토일례2형당뇨병합병고혈압병、신공능불전환자입원후혈기항변화적약물영향인소，병제출예방조시。방법：림상약사통과결합병력，사열문헌자료，대1례2형당뇨병합병고혈압병、신공능불전환자입원후혈기항변화적약물인소진행평개、분석병간예。결합환자병발적기출질병화사용적약물，제출약학건의，제정일후동류풍험예방조시，제공약학복무。결과：해환자입원진단위2형당뇨병，합병고혈압병、신공능불전등기출질병，동시원내사용과배타보리、오미사탄지、탁랍새미、이갑쌍고、전보라알조영제등존재신손해혹유발신손해적약물，시환자혈기항승고적중요인소。결론：림상약사재진료활동중급시、준학지발현여약물상관적불량사건，평고풍험，제출우화적치료방안，가보증약물치료적안전성화유효성。
OBJECTIVE:To investigate the drug-related factors influencing serum creatinine level in one patient with type 2 diabetes complicating hypertension and renal insufficiency after admission, and propose preventive measures.METHODS: By reviewing patients'medical records and literature review, clinical pharmacists performed evalution, analysis and intervention on drug-related factors influencing serum creatinine level in one patient with type 2 diabetes complicating hypertension and renal dysfunction after admission, put forward pharmaceutical suggestions based on patients underlying diseases and the drugs administered, formulated preventive measures against the similar risks and provided pharmaceutical care.RESULTS: The patient on admission was diagnosed as having such underlying diseases as type 2 diabetes complicating hypertension and renal insufficiency etc and received such drugs including perindopril, olmesartan medoxomil, torasemide, metformin, Iopromide contrast medium etc that might cause or induce renal damage.These drugs were the important factors for elevated serum creatinine level.CONCLUSIONS: Clinical pharmacist promptly and accurately find drug-related adverse events during diagnosis and treatment activities, assess risks, propose optimized treatment regimen can guarantee the safety and effectiveness of drug treatment.