1例心房颤动并发痛风发作患者自服NSAIDs诱发上消化道出血的用药分析与药学监护  

Medication analysis and pharmaceutical care of upper gastrointestinal bleeding induced by self-administered NSAIDs in a patient with atrial fibrillation complicated by gout attack

作　　者：李晓娟 张青霞[1] LI Xiao-juan;ZHANG Qing-xia(Department of Pharmacy,Xuanwu Hospital,Capital Medical University,National Clinical Research Center for Geriatric Disease,Beijing 100053,China;Department of Pharmacy,Fengnan District Hospital,Tangshan City,Tangshan 063300,China)

机构地区：[1]首都医科大学宣武医院药学部,国家老年疾病临床医学研究中心,北京100053 [2]唐山市丰南区医院药剂科,河北唐山063300

出　　处：《实用药物与临床》2022年第9期825-829,共5页Practical Pharmacy and Clinical Remedies

基　　金：国家重点研发计划资助(2020YFC2008305);北京市科学技术委员会“老年人多重用药管理模式的建立与临床应用研究”专项资助课题(D181100000218002)。

摘　　要：目的探讨1例心房颤动并发痛风发作患者自服非甾体抗炎药(NSAIDs)诱发上消化道出血的用药分析与药学监护。方法临床药师参与1例心房颤动并发痛风发作患者自服NSAIDs诱发上消化道出血的临床治疗,协助医师制定抗栓以及抗痛风方案,并对患者进行全程化的药学监护。结果临床药师发挥专业特长,针对消化道出血后重启抗栓药物时机以及消化道出血患者伴发急性痛风选择何种抗炎止痛药物提出合理建议,并同时关注药品不良反应,患者最终症状好转出院。结论临床药师通过参与1例心房颤动并发痛风发作患者自服NSAIDs诱发上消化道出血的临床治疗,提供个体化的用药方案及用药监护,并及时识别药品不良反应,在临床治疗过程中发挥了积极的作用。Objective To explore the medication analysis and pharmaceutical care of upper gastrointestinal bleeding induced by self-administered NSAIDs in a patient with atrial fibrillation complicated by gout attack.Methods Clinical pharmacists participated in the medication of upper gastrointestinal bleeding induced by self-administered NSAIDs in a patient with atrial fibrillation complicated by gout attack,assisted doctors to formulate antithrombotic and anti-gout programms,and carried out the whole-process pharmaceutical care for the patient.Results Clinical pharmacists gave full play to their professional expertise and put forward reasonable suggestions on the timing of reactivating antithrombotic drugs after gastrointestinal bleeding and the selection of anti-inflammatory and analgesic drugs for patients with gastrointestinal bleeding complicated with acute gout.Meanwhile,they also paid attention to adverse drug reactions,so that the symptoms of patients were eventually improved and were discharged.Conclusion Clinical pharmacists participate in the clinical treatment of upper gastrointestinal bleeding induced by NSAIDs in a patient with atrial fibrillation complicated by gout attack,provide individualized medication regimen and medication monitoring,and timely identify adverse drug reactions,playing a positive role in the clinical treatment processing.

关 键 词：心房颤动 上消化道出血 抗栓治疗 痛风急性发作 用药监护 

分 类 号：R969.3[医药卫生—药理学]