Treatment Analysis of One Case of Chronic Heart Failure, Chronic Renal Insufficiency and Gout Patients with Sustained Pain in Lower Limbs / 中国药师

ABSTRACT

One 80-year-old male patient was admitted to the hospital because of repeated palpitation and shortness of breath for more than 10 years and repeated swelling and pain in his hands and feet for 8 years. After the admission, the diagnosis was mitral stenosis ( moderate) with insufficiency (severe), gradeⅣheart function, chest infection, pulmonary infection, chronic renal insufficiency (CKD 3), gouty arthritis and the other chronic diseases. Diuresis, anticoagulation and uric acid lowering treatment were given after the admis-sion. The pain in the left lower extremity of the patient recurred and gradually worsened. The single application of hormones relieved the pain quickly without heart failure, while the effective duration was short. Therefore, in order to avoid long-term application of hormones or NSAIDs with heart failure risk and prevent gout attack better, and according to colchicine past used in the patient with diarrhea, clini-cal pharmacists suggested to try lower dose of colchicine 0. 25 mg qd, and observed the tolerance of the patient. Clinical pharmacists thought the reasons for the repeated gout attacks were related with such chronic diseases as heart failure and renal insufficiency etc, which limited the safety and effectiveness of the selection and application of acute gout treatment drugs. Based on the above analysis, clinical pharmacists carried out drug education for the patient and his family members to ensure the safety and effectiveness of medication.