1例老年冠心病患者使用造影剂药学监护.pdfVIP

中国药物应用与监测2011年10月第8卷第5期 Chinese Journal of Drug Application and Monitoring, Vol.8, No.5, October 2011 1例老年冠心病患者使用造影剂的药学监护 1 2 1 （1. 解放军总医院药品保障中心，北京 100853 ；2. 解放军总医院南楼心血管一科，北京 100853 ） 王东晓 ，马锦玲 ，朱　曼 [摘要] 目的：探讨老年冠心病患者使用造影剂时的药学监护内容。方法：临床药师通过对1例使用造影剂的老年冠心病患 者开展的药学监护服务，探讨如何选择适宜的切入点，对可能发生的造影剂肾损伤进行药学监护。结果：造影剂肾损伤有多 种危险因素，主要与患者的基础疾病、肾功能情况、用药种类等相关，临床药师可以把选择合适的造影剂种类及用量、分析 潜在肾毒性药物及药物相互作用等作为药学监护的切入点。结论：应深入了解造影剂肾损伤的发病机制、危险因素、预防措 施等，结合患者特点，慎重选择适宜的造影剂及其用量、撤除潜在肾毒性药物等，开展针对造影剂的个体化药学监护。 [关键词] 临床药师；药学监护；造影剂；急性肾损伤 [ 中图分类号] R981；R969.3 [文献标识码] A [文章编号] 1672 – 8157(2011)05 – 0292 – 04 Pharmaceutical care on an old patient with coronary heart disease using contrast media 1 2 1 WANG Dong-xiao , MA Jin-ling , ZHU Man ( 1. Department of Pharmaceutical Care, PLA General Hospital, Beijing 100853, China; 2. Department of Cardiology, PLA General Hospital, Beijing 100853, China ) [ABSTRACT] Objective: To explore pharmaceutical care on old patients with coronary heart disease (CHD) using contrast media. Methods: The pharmaceutical care for an old CHD patient using contrast media was analyzed, and the suitable solution of pharmaceutical care of contrast media-induced acute renal injury was carried out. Results: Among various risk factors, contrast media-induced nephrotoxicity was mainly related to the patient ’s primary illness, renal function and medication. Clinical pharmacist could carry out the pharmaceutical care for patients using contrast media by selecting correct contrast media, controlling the volume of contrast media, avoiding using drugs with potential renal toxicity, paying attention to possible drug interactions, and so on. Conclusion: Clinical pharmacists should deeply learn about the pathogenesis, risk factors and precaution of CIN, make clear the patient ’s individual characteristic, cautiously choose the kind and the dosage of contr