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OBJECTIVE To provide a reference for the safe use of drugs in patients with complex venous thromboembolism （VTE） and acute renal insufficiency. METHODS Clinical pharmacists participated in the management of anticoagulant therapy for a patient with complex VTE complicated with acute renal insufficiency， and evaluated the patient as high-risk thrombosis and bleeding based on their medical history， laboratory test results， etc.； combined with the complexity of thrombosis and renal insufficiency， clinical pharmacists suggested that enoxaparin sodium should be used in the acute stage of thrombosis （5 to 21 days after onset）， and then warfarin should be adopted for oral anticoagulation treatment. Because the patient’s anticoagulation was not up to the standard （the target range of the international normalized ratio was 2-3）， clinical pharmacists suggested increasing the warfarin dose， detecting the warfarin metabolism genotype， and adjusting the warfarin dose according to the genotype； at the same time， clinical pharmacists developed an anticoagulation monitoring plan to ensure the safety of anticoagulation treatment. RESULTS Doctors had adopted all the recommendations of clinical pharmacists. The patient did not experience adverse events such as bleeding or worsening of thromboembolism during anticoagulation in the hospital. When the anticoagulation met the standards， the patient was allowed to be discharged with medication. CONCLUSIONS By participating in the anticoagulation treatment management of patients with complex VTE and acute renal insufficiency， clinical pharmacists have assisted doctors in formulating personalized anticoagulation plans to promote the compliance with the anticoagulation treatment standard and ensure the safety and effectiveness of medication for patients.
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Based on our experience in treating one patients with non-small cell lung cancer complicated with hyperthyroidism,the following considerations in immunotherapy and pharmaceutical care are proposed:role of iodine contrast and contrast agent selection in patients with hyperthyroidism;selection of hemostatic agents and assessment of thrombosis risk in patients with hemoptysis caused by tumor invasion of bronchus;influence of glucocorticoid use on the treatment with programmed cell death-1(PD-1)inhibitor and the role of PD-1 inhibitors in patients with a history of hyperthyroidism;education methods for patients refuse to receive opioids.The participation of clinical pharmacists in the Multiple Disciplinary Team and the multi-dimensional pharmaceutical monitoring for patients can improve the safety and rationality of medications.
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Objective: To share the anti-infection experience for the patients with complicated intra-abdominal infection after operation.Methods: The whole course of drug administration participated by clinical pharmacist in one patient with complicated intra-abdominal infection after pancreatoduodenectomy were retrospectively analyzed and discussed.Results: Enterococcus was found in the blood culture and ascites.According to the results of drug sensitive tests, clinical pharmacist provided medication suggestions and performed medication mornitoring.According to the blood concentration, clinical pharmacist adjusted the dose of vancomycin, and changed the therapy regimen according to the changes of conditions.As a result, adverse reactions were controlled timely, and satisfactory treatment effects were obtained.Conclusion: The aetiology of complicated intra-abdominal infection is complex with intractable treatment, and the participation of clinical pharmacists in the treatment can improve the efficiency and safety.
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INTRODUÇÃO: A partir do último século, observou-se aumento na expectativa de vida e na incidência de patologia na população idosa, principalmente doenças crônicas. OBJETIVO: Avaliar o efeito do acompanhamento farmacoterapêutico (AF) em pacientes dislipidêmicos de um lar de idosos da cidade de Novo Hamburgo, RS. METODOLOGIA: Trata-se de estudo quantitativo, observacional com delineamento longitudinal retrospectivo, que avaliou 50 pacientes idosos residentes de um lar geriátrico (80,2 ± 7,64 anos, 32 mulheres). Foi avaliado o perfil lipídico desses pacientes (colesterol total, triglicerídeos, HDL e LDL) antes e após AF de um ano. A análise dos resultados ocorreu por meio de estatística descritiva e teste t Student ou U de Mann Whitney para amostras pareadas. RESULTADOS: 56% dos pacientes apresentaram alteração no perfil lipídico no início do estudo e, 30% ao final, ocorrendo significativa melhora após o AF. Além disso, os níveis de colesterol total apresentaram diminuição favorável após um ano de acompanhamento (206 ± 53 vs. 180 ± 43 mg/dL; P = 0,009). A maioria dos pacientes que apresentou diagnóstico de dislipidemia utilizava medicamentos há pelo menos três meses para o tratamento dessa patologia (estatinas e fibratos). A maioria desses pacientes utilizava os medicamentos de forma correta. CONCLUSÃO: Conclui-se que os pacientes tiveram melhora no seu perfil lipídico após um ano de acompanhamento.
INTRODUCTION: Since the last century, life expectancy and the incidence of disease in the elderly have increased, especially chronic diseases. OBJECTIVE: This study aims to evaluate the pharmacotherapeutic follow-up(PF) in dyslipidemic patients of a nursing home in Novo Hamburgo city, state of Rio Grande do Sul, Brazil. METHODOLOGY: This is a quantitative, observational study with a longitudinal retrospective design, evaluating 50 elderly patients who live in a nursing home (80.2 ± 7.64 years old, 32 women). We assessed the lipid profile of these patients (total cholesterol, triglycerides, HDL and LDL) before and after one-year PF. The analysis was conducted through descriptive statistics and Student t test or U of Mann Whitney test for paired samples. RESULTS: 56% of the patients presented changes in lipid profile in the beginning of the study and 30% one year later, with significant improvement of the lipid profile after the monitoring. Moreover, total cholesterol levels showed a favorable decrease after a year of monitoring (206 ± 53 vs. 180 ± 43 mg/dL; P = 0.009). Most patients diagnosed with dyslipidemia were using drugs, for at least three months, to treat this pathology (statins and fibrates). The majority of these patients used them correctly. CONCLUSIONS: The patients had significant improvement in their lipid profile after one year of monitoring.
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OBJECTIVE:To discuss rational use of injection in order to provide reference for rational use of injection in the clinic. METHODS:Drug use was analyzed in respect of route of administration,selection of solvent,compatibility of drugs, speed of intravenous administration,the concentration of mixture,etc. RESULTS&CONCLUSION:There are some mistakes in the application of injections,but some faults and adverse drug reactions (ADRs) can be warned early. By strengthening pharmaceutical monitoring,related faults and ADRs can be reduced to the minimum.
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OBJECTIVE:To provide suggestions for the development of training mode for pharmaceutical monitoring personnel in China.METHODS:The training mode of Office of Regulatory Affair University(ORA U) was introduced to analyze the difference of training mode for pharmaceutical monitoring personnel between China and America.RESULTS & CONCLUSIONS:America has established a systematic,continuous and uniform pharmaceutical monitoring personnel training system,which is more flexible and advanced than that in China.Our country could draw experiences from the training mode of FDA personnel to develop uniform and diversified training system with suitable budget mechanism.
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OBJECTIVE:To realize the current situation of patient's compliance with medication in Tibetan and to evaluate the methods of increasing patient's compliance METHODS:Questionnaire inquisition was adopted in 188 Tibetan patients to investigate the type of diseases,situation of medication and condition of compliance RESULTS:The compliance with medication was related with the type of diseases,patient's educational background and knowledge about diseases It was a good way to raise the patient's compliance that the patient's recognition of diseases and pharmacotherapy should be improved and communication between doctor and patient and guidance on drug use should be enhanced CONCLUSION:Aiming at patients in different ages,the subject matter of medication consultation service should not be the same