Anticoagulant Therapy for an Acute Pulmonary Embolism Patient with Renal Insufficiency and Thrombo-cytopenia / 中国药师

ABSTRACT

The article analyzed an anticoagulant treatment regimen for a patient with acute pulmonary embolism and discussed the drug treatment strategy when the patient had renal insufficiency and thrombocytopenia. After fully evaluating the advantages and disad-vantages, unfractionated heparin was firstly applied under the monitoring of activate partial thrombin time, platelet counts and hemor-rhage. When the renal function was improved, low molecular weight heparin replaced unfractionated heparin. Finally, long-term warfa-rin therapy was conducted. The efficacy monitoring included symptoms, thrombosis,respiratory cycle indicators and indicators of extra-pulmonary organ function, such as serum creatinine, transaminases and pro-brain natriuretic peptides. Adverse reaction monitoring in-cluded bleeding and assessing the risk of heparin-related thrombocytopenia based on the characteristics of reduced platelet counts. After the adequate anticoagulant therapy, the patient's symptoms were relieved, liver and kidney functions were improved without significant bleeding and heparin-related thrombocytopenia. When patients have a variety of complications resulting in increased risk of drug treat-ment, the treatment regimen should be based on drug efficacy and adverse reaction characteristics. Assessing patients' prognosis and choosing a controllable treatment regimen are the keys to reducing treatment risk.