Individualized Pharmaceutical Care for One Patient with End-stage Renal Disease and Atrial Fibrillation after Aortic Valve Replacement / 中国药师

ABSTRACT

Objective:To explore the importance and the breakthrough points of pharmaceutical care for patients with renal disease,especially using drugs with narrow therapeutic window and notable individual difference.Methods:Digoxin concentration and international normalized ratio (INR) were detected by clinical pharmacists,and then individualized pharmaceutical care was given to the patient according to the monitoring results.Results:Physician increased the monitoring frequency and adjusted the drug usage according to the patient's renal function.The patient's condition was improved and understood the necessity of related index monitoring.Conclusion:Clinical pharmacists can assist physicians in optimizing the treatment,and ensure safe,reasonable and effective medication by providing pharmaceutical care in various aspects.