临床药师对老年心力衰竭合并房颤及肾功能不全患者地高辛中毒的药学监护  

Pharmaceutical care of digoxin poisoning in an elderly patient with heart failure complicated with atrial fibrillation and renal insufficiency by clinical pharmacists

作　　者：刘秀梅 华之卉 毛新奇 陈楠 都丽萍[3] LIU Xiumei;HUA Zhihui;MAO Xinqi;CHEN Nan;DU Liping(Department of Pharmacy,the People’s Hospital of He’nan University of Chinese Medicine(the People’s Hospital of Zhengzhou),Zhengzhou 450003,China;the Fifth Clinical Medical College of He’nan University of Chinese Medicine,Zhengzhou 450003,China;Department of Pharmacy,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]河南中医药大学人民医院(郑州人民医院)药学部,郑州450003 [2]河南中医药大学第五临床医学院,郑州450003 [3]中国医学科学院北京协和医学院药剂科,北京100730

出　　处：《上海医药》2021年第9期49-51,59,共4页Shanghai Medical & Pharmaceutical Journal

基　　金：河南省医学科技攻关项目(LHGJ20191090);河南省中医药科学研究专项课题(2018ZY3017);河南省医学科技攻关项目(2018020846)。

摘　　要：目的 :探讨临床药师对老年心力衰竭合并房颤及肾功能不全患者地高辛中毒治疗方案中的作用及药学监护切入点。方法 :临床药师通过参与老年心力衰竭合并房颤及肾功能不全患者地高辛中毒的治疗,从地高辛中毒的鉴别、地高辛血药浓度监测、临床药物治疗方案调整等环节提供药学建议。调整药物治疗方案后,患者地高辛中毒表现逐渐好转,入院第19天患者病情稳定出院。结果:临床药师在老年心力衰竭地高辛中毒的治疗过程中,通过分析患者用药情况,结合临床症状,及时进行用药调整,积极开展个体化药学监护。结论 :临床药师参与地高辛中毒患者的治疗过程,提高了患者用药的安全性和有效性。Objective:To explore the role of clinical pharmacists in the treatment of digoxin poisoning in an elderly patient with heart failure complicated with atrial fibrillation and renal insufficiency and the entry point of pharmaceutical monitoring.Methods:The clinical pharmacists provided pharmaceutical advice from the aspects of the identification of digoxin poisoning,the monitoring of digoxin blood concentration and the adjustment of clinical drug treatment plan by participating in the treatment of digoxin poisoning in the elderly patient.After adjusting the drug treatment plan,the digoxin poisoning of the patient was gradually improved,and she was discharged due to stable condition on the 19th day of admission.Results:The clinical pharmacists timely adjusted medication and actively carried out individual pharmaceutical monitoring by the analysis of the patients’medication and combining with clinical symptoms in the treatment process of the elderly patient.Conclusion:The safety and effectiveness of the drug use can be improved by clinical pharmacist participating in the treatment process of digoxin poisoning patient.

关 键 词：心力衰竭 地高辛中毒 药学监护 

分 类 号：R972.1[医药卫生—药品] R969.3[医药卫生—药学]