1例老年人急性期照护单元老年患者多重用药分析  

A Case of Elderly Patient with Polypharmacy in ACE Unit

作　　者：尹茜[1] 曹立[2] YIN Xi;CAO Li(Department of Pharmacy,National Clinical Reserch Center for Geriatrics,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Geriatrics,National Clinical Reserch Center for Geriatrics,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院药剂科,成都610041 [2]四川大学华西医院老年医学中心,国家老年疾病临床医学研究中心,成都610041

出　　处：《医药导报》2022年第3期406-409,共4页Herald of Medicine

基　　金：四川省科技厅重点研发项目(2017FZ0096)。

摘　　要：目的分析总结1例多系统疾病老年危重患者在老年人急性期照护(ACE)单元多学科团队照护下的住院经过,为多重用药老年患者的治疗提供借鉴。方法梳理患者疾病治疗过程、药物不良反应发生及处理、用药选择的权衡和决策,探讨多重用药中地高辛中毒、华法林的药物相互作用、心房颤动的控制、抗凝治疗与出血风险的矛盾等治疗难题。结果患者在临床药师参与的多学科照护下,达到了最好的用药平衡,避免了更多的药物不良反应,转危为安,病情平稳后出院。结论临床药师以多学科团队成员的形式参与多病共存老年患者多重用药管理,提高了用药安全性和合理性,增加了患者的获益。Objective To analyze and summarize the hospitalization history of a critically ill elder patient with multiple system diseases taken care by a multidisciplinary team in the acute care unit for the elderly(ACE unit),in order to provide a reference the treatment of elder patients with polypharmacy.Methods The process of treatment,adverse drug reactions,and adjustment of medication regimen were analyzed.And some problems we met in the treatment were discussed,such as digoxin poisoning,warfarin drug interaction,atrial fibrillation controlling,and the conflict between anticoagulation therapy and the risk of bleeding.Results Under the multidisciplinary care,the patient reached the medication balance,avoided more adverse drug reactions,and discharged from hospital in the end.Conclusion A pharmacist attending in an ACE group will improve safety and rationality of the medication regimen and help those geriatric patients to recover.

关 键 词：多重用药 多学科照护 老年患者 

分 类 号：R969.3[医药卫生—药理学]