摘要
临床药师对1例长期口服达比加群酯发生出血的患者实施全程化药学监护,分析出血原因可能与肾衰竭导致的达比加群蓄积有关,建议及时给予依达赛珠单抗逆转抗凝治疗,使患者的凝血功能迅速恢复正常。逆转第3日患者凝血象出现反弹,临床药师分析原因可能与达比加群组织重新分布有关,建议采取透析清除达比加群,患者凝血象逐步恢复正常。凝血功能稳定后,临床药师对重启抗凝药物时机和药物选择进行分析,建议选择华法林重启抗凝,最大限度地降低了患者的大出血和血栓栓塞的风险。
The clinical pharmacist performed full-course pharmaceutical care on a patient suffered from hemorrhage considering caused by renal failure after long-term oral administration of dabigatran etexilate,and suggested that idarucizumab should be given to reverse anticoagulation therapy in time,then the patient’s coagulation function returns to normal quickly.On the third day of reversal,the patient’s coagulation rebounded.The clinical pharmacist considered this may related to the redistribution of dabigatran in tissues,and recommended taking dialysis to remove dabigatran.Finally,the coagulation function of patient returned to normal.After the coagulation function was stabilized,the clinical pharmacist analyzed the timing of restarting anticoagulant drugs and drug selection,and suggested that warfarin should be selected,which minimized the risk of hemorrhage and thromboembolism of the patient.
作者
武明芬
朱斌
吴汀溪
赵志刚
WU Ming-fen;ZHU Bin;WU Ting-xi;ZHAO Zhi-gang(Department of Pharmacy,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070)
出处
《中南药学》
CAS
2021年第5期1005-1009,共5页
Central South Pharmacy
基金
中国毒理学会临床毒理专项研究课题(No.CST2019CT302)。
关键词
达比加群酯
出血
抗凝逆转
依达赛珠单抗
药学监护
dabigatran etexilate
hemorrhage
anticoagulation reversal
idarucizumab
pharmaceutical care
