心房颤动患者1例安全使用华法林的药学监护

发布时间：2018-05-25 03:16

本文选题：华法林 + 甘草　；参考：《中国临床药理学杂志》2017年16期

【摘要】：目的探讨临床药师在华法林安全使用中的作用。方法对1例心房颤动患者进行药学监护。患者入院第2天测凝血酶原时间(PT)33.5 s,国际标准化比值(INR)2.82;因感冒咳嗽加用复方甘草口服溶液,2 d后监测凝血四项显示PT升至38.4 s,INR升至3.38;临床药师分析患者所用药物中,复方甘草口服溶液可增强华法林的抗凝作用,建议停用华法林,行华法林基因多态性检测帮助确定华法林使用剂量。结果与结论患者INR值逐步回落,华法林调整至维持剂量每日2.5 mg。临床药师参与华法林相互作用的查找及个体化剂量的制定,保证患者的用药安全。
[Abstract]:Objective to explore the role of clinical pharmacists in the safe use of warfarin. Methods A patient with atrial fibrillation was monitored by pharmacology. On the second day of admission, the prothrombin time (PTT) was measured for 33.5 s, and the international standardized ratio (INR) was 2.82.The four items of blood coagulation were detected to increase to 38.4 s, INR and 3.38 after 2 days of cold cough plus compound liquorice oral solution, and the clinical pharmacists analyzed the drugs used by the patients. Compound Glycyrrhiza uralensis can enhance the anticoagulant effect of warfarin. It is suggested that warfarin should be stopped and warfarin gene polymorphism test should be carried out to help determine the dosage of warfarin. Results and conclusion the INR value of patients decreased gradually and warfarin was adjusted to 2. 5 mg per day. Clinical pharmacists are involved in the determination of warfarin interactions and individual doses to ensure the safety of medication.
【作者单位】：南京大学医学院附属鼓楼医院药学部;
【分类号】：R541.75

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