ABSTRACT
Objective: To investigate the role of clinical pharmacist in anticoagulant therapy.Methods: Clinical pharmacist participated in the anticoagulant treatment adjustment for one patient with deep vein thrombosis (DVT) of lower limbs.Clinical pharmacist assessed the risk factors of DVT and the bleeding risk of anticoagulant therapy, provided suggestions in case of over-anticoagulation with warfarin, and offered medication education to the patient with unsatisfactory compliance.Results: Physician adopted the suggestions of clinical pharmacist, INR was within the rational range, and the patient was discharged with stable condition.Conclusion: The participation of clinical pharmacist in the anticoagulation with warfarin can reduce the risks of drug use and promote the efficacy and safety of medication effectively.
ABSTRACT
Objective To investigate the role of clinical pharmacist in medical therapy for a patient with cerebrovascular disease and epilepsy.Methods One patient was hospitalized due to headache and twitch.Clinical diagnosis was cerebral venous sinus thrombosis and epilepsy.During the treatment,the clinical pharmacist gave suggestion on drug selection of anti-infection and anti-epileptic therapy,assessed drug interaction between omeprazole-escitalopram and mannitoldexamethasone,monitored the adverse drug reaction of valproate,and provided medication education to the patient.Results Physician adopted clinical pharmacist's suggestion.The patient discharged with stable condition.Conclusion The participation of clinical pharmacists in the medication therapy of patients with cerebrovascular disease can reduce the risk of drug use and promote the efficacy and safety of medication.