RESUMO
Objective: To investigate the principles of rational drug use for the patients suffering from heart failure complicated with diuretic-induced gouty arthritis.Methods: The clinical pharmacist participated in the diagnosis, treatment and drug adjustment of one patient suffering from heart failure complicated with furosemide-induced gouty arthritis.Taking the disease symptoms and potential gouty-inducing drugs into full consideration, clinical pharmacist suggested the withdrawal of related-drugs and the adjustment of treatment plan.Results: Considering the characteristics of the patient, clinical pharmacist adjusted the rational drug treatment.After the adoption of the suggestions, the gouty symptoms were relieved, heart failure was controlled and the condition was improved.Conclusion: Loop diuretics can easily trigger an acute attack of gout, especially for the patients with heart failure and gout history.Clinical pharmacist can make full use of professional advantages to optimize the treatment plan in order to reduce adverse reactions and promote the rational drug use by participating in clinical practice.
RESUMO
Objective To describe the effect of loop diuretic on renal function in patients with chronic heart failure.Methods Data were of 211 impatients diagnosed as HF collected in a nested case-control study.The association of application of loop diuretic with renal function was assessed to identify whether loop diuretic was an independent risk factor of worsening renal function(WRF).To identify WRF,we defined serum creatinine level as a rise ≥26.5 μmol/L compared to the level at admission.Therefore,the subjects were divided into case group(serum creatinine level ≥ 26.5 μmol/L,n =66)and control group(serum creatinine level ＜ 26.5μmol/L,n =145).Results The doses of loop diuretic were higher in the case group([385.17 ± 49.37]mg)than the control group([244.50 ± 34.82]ag)(P ＜ 0.05),but it was not independent risk factor of WRF (P＞0.05).Creatinine level and NYHA class at admission were independent risk factor for WRF,with OR of 2.248(95 ％ CI:1.088-4.647)and 2.485(95 ％ CI:1.385-4.459)respectively(Ps ＜ 0.05).Conclusion The doses ofloop diuretic were not independent risk factor of WRF,creatinine level and severity of HF at admission are the most important predictors of the occurrence of WRF.