华法林引起严重出血的原因分析及药学监护  

Analysis and pharmaceutical care for a serious bleeding event due to warfarin

作　　者：吴桂月[1] 伏晓[1] 代大顺[1] 

机构地区：[1]河南省中医院药学部,郑州450002

出　　处：《中南药学》2016年第5期555-557,共3页Central South Pharmacy

摘　　要：目的探讨临床药师在华法林个体化抗凝治疗与用药监护中的工作方法。方法以1例华法林引起严重出血患者的抗凝治疗为切入点,分析该患者使用华法林出血的影响因素,参与药物治疗方案的选择,实施药学监护。结果华法林的抗凝作用受多种因素影响,患者的身体状况(急性脊髓炎、尿路感染、低蛋白血症)及合并用药(布洛芬缓释胶囊、甲泼尼龙琥珀酸钠注射液、注射用灯盏花素)可能是导致严重出血的原因。结论临床药师应围绕患者的抗凝方案,关注华法林与食物及药物的相互作用,监测药物不良反应,指导并教育患者合理使用华法林。Objective To explore the working method of clinical pharmacists in individualized anticoagulant therapy and pharmaceutical care. Methods One case of serious bleeding caused by warfarin was analyzed. Clinical pharmacists participated in the design of the therapeutic regime and the performance of pharmaceutical care. Results Warfarin is influenced by many factors and has a high probability of inducing adverse reactions. The patient＇s sphysical condition （acute myelitis, urinary tract infection and hypoalbuminemia） and drug inter- action （ibuprofen sustained-release capsules, methylprednisolone sodium succinate for injection and Brevis- capine injection） may induce serious bleeding. Conclusion Clinical pharmacists should focus on anticoagulant regimen, and pay attention to warfarin interaction with food and medicines, as well as monitoring adverse drug reactions, guiding and educating the rational use of warfarin.

关 键 词：华法林 抗凝管理 药物相互作用 药学监护 

分 类 号：R96[医药卫生—药理学]