急性心力衰竭合并心房颤动患者中西药学监护1例  

A case of Chinese and Western pharmaceutical care for a patient with acute heart failure complicated with atrial fibrillation

作　　者：齐呈媛 梁艳[2] 王莹[2] 薛春苗[2] 卞丽 QI Chengyuan;LIANG Yan;WANG Ying;XUE Chunmiao;BIAN Li(Department of Pharmacy,Beijing Gulou Chinese Medicine Hospital,Beijing100009,China;Department of Pharmacy,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing100700,China;Department of Pharmacy,Lianyungang Xuwei New District People’s Hospital,Jiangsu Province,Lianyungang222000,China)

机构地区：[1]北京市鼓楼中医医院药剂科,北京100009 [2]北京中医药大学东直门医院药学部,北京100700 [3]江苏省连云港徐圩新区人民医院药剂科,江苏连云港222000

出　　处：《中国医药导报》2024年第31期183-187,共5页China Medical Herald

基　　金：国家中医药管理局高水平中医药重点学科建设项目(zyyzdxk-2023257)。

摘　　要：急性心力衰竭可在短时间内迅速发生失代偿或恶化,合并心房颤动可进一步加重病情,增加死亡风险。因此,采取早期积极的治疗方案和密切监护十分重要。本文报道临床药师对北京中医药大学东直门医院1例老年患者的药学监护,及时对医师重复使用具有肝毒性中成药的问题进行用药干预,避免不良反应的发生。在医师使用袢利尿剂联合螺内酯改善心力衰竭症状的前提下,根据经验性补钾的问题提出循证建议,促进临床合理用药,保障患者用药安全性。本文分析患者皮下出血的危险因素,梳理导致皮下出血联用的药品,加强用药期间的监护,确保用药安全,为临床联合用药提供参考,并为患者提供完善的药学服务。经系统治疗,患者已安全度过心力衰竭急性期,且心房颤动未再发作。Acute heart failure can rapidly decompensate or deteriorate in a short period of time,and patients with atrial fibrillation will further aggravate their condition,and increase the risk of death.Therefore,it is very important to adopt an early and active treatment plan and closely monitor.This paper reports pharmaceutical care of a case of elderly patients in Dongzhimen Hospital,Beijing University of Chinese Medicine by clinical pharmacists,timely intervenes in the repeated use of hepatotoxic traditional Chinese patent medicines,and avoids the occurrence of adverse reactions.On the premise that physicians use loop diuretics combined with spironolactone to improve the symptoms of heart failure,evidence-based recommendations are provided based on empirical potassium supplementation to promote rational clinical drug use,and ensure patient medication safety.This article analyzes the risk factors for subcutaneous bleeding in patients,identifies the drugs that can cause subcutaneous bleeding when used in combination,strengthens monitoring during medication,ensures medication safety,provides reference for clinical combination therapy,and offers comprehensive pharmaceutical services for patients.After systematic treatment,the patient has safely passed the acute phase of heart failure,and has not experienced any recurrence of atrial fibrillation.

关 键 词：临床药师 药学监护 急性心力衰竭 肝功能 血钾 

分 类 号：R541.6[医药卫生—心血管疾病]