Pharmaceutical care of a critical patient with acute heart failure after PCI by clinical pharmacists / 中国药房

ABSTRACT

OBJECTIVE To explore the role of clinical pharmacists in the treatment of critical patients with acute heart failure after percutaneous coronary intervention （PCI）， and to provide reference for drug treatment and monitoring of such patients. METHODS Clinical pharmacists participated in the treatment of a critical patient with acute heart failure after PCI， and assisted physicians to jointly develop individualized medication plans based on domestic and foreign literature： it was suggested to give imipenem and cilastatin for anti-infective therapy， adjust drug dose according to renal function， and timely descend step therapy； Levetiracetam tablets were selected to prevent epilepsy； the differential diagnosis and treatment of rhabdomyolysis possibly caused by Atorvastatin calcium tablets were performed； the whole process of pharmaceutical care was conducted. RESULTS Physicians adopted the suggestions of clinical pharmacists. The acute heart failure of the patient was controlled， the pulmonary infection was improved， the adverse reaction symptoms were relieved， and the patient was successfully transferred out of the ICU. CONCLUSIONS For severe patients， when giving imipenem and cilastatin for anti-infection treatment，the clinical pharmacist should adjust the dose according to the patient’s renal function and be alert to the possible neurotoxicity. During the treatment with Atorvastatin calcium tablets，the clinical pharmacist should comprehensively analyze the risk of rhabdomyolysis. For the adverse reactions that have occurred， clinical pharmacist should promptly address symptomatic issues to ensure the safety and effectiveness of medication for patients.