1例男性青年难治性高血压的药学监护分析

doi:10.3969/j.issn.1672-3384.2016.06.016

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摘要临床药师通过参与临床药物治疗，进行药学监护，协助临床医生进行 1 例男性青年难治性高血压的治疗。药师参与患者初始治疗方案选择，并根据相应指南和共识参与治疗药物调整并开展安全性、有效性、依从性药学监护及患者用药教育，参与患者在院期间多种药物的调整，血压由入院 165/98 mmHg 降至出院 143/84 mmHg（1 mmHg=0.133 kPa），心率入院80 次/ 分至出院63 次/ 分，尿酸由入院594 μmol?L-1 降至出院510 μmol?L-1，血肌酐入院224 μmol?L-1 至出院216 μmol?L-1，血钾在院期间无较大波动。患者未出现因血压改变导致头晕跌倒等恶性事件，并开始记录血压日志，治疗依从性良好。临床药师与医师在沟通中学习心内科医师治疗难治性高血压的经验知识，加深对难治性高血压诊治的认识，关注细节、对比联系，这也是临床药师开展药学监护工作的出发点。

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	胡扬
	赵振营
	王辉
	张波

关键词 ：难治性高血压, 药学监护, 临床药师, 青年

Abstract：To explore the method of pharmaceutical care on a young male patient with resistant hypertension. The clinical pharmacist participated in developing the drug therapy plan, monitoring the patient's progress in achieving the specific outcomes. The pharmacist also assured that the patient has a thorough understanding of the disease and the therapy/medications prescribed in this plan. The key monitoring points included initial regimen selection, medication adjustment, efficiency, safety and compliance monitoring, and patient education. With the treatment, the blood pressure of the patient decreased gradually from 165/98 mmHg to 143/84 mmHg, heart rate from 63/min to 80/min , serum uric acid from 594 μmol?L-1 to 510 μmol?L-1, serum creatinine from 224 μmol?L-1 to 216 μmol?L-1, serum potassium almost stable. No serious adverse drug reactions occurred and patient compliance was improved. Involvement of clinical pharmacist in clinical therapeutic team and taking pharmaceutic al care will improve the efficacy of clinical pharmacotherapy .

Key words： resistant hypertension pharmaceutical care clinical pharmacist young

:	R974
	R944

基金资助:国家临床重点专科建设项目（国卫办医函[2013]544 号）

通讯作者: 张波 E-mail: elieenhuyang@163.com

引用本文:

胡扬，赵振营，王辉, 张波. 1例男性青年难治性高血压的药学监护分析[J]. 临床药物治疗杂志, 2016, 14(6): 68-73.
HU Yang, ZHAO Zhen-ying, WANG Hui, ZHANG Bo. Pharmaceutical care on a young male patient with resistant hypertension. CLINICAL MEDICATION JOURNAL, 2016, 14(6): 68-73.

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http://www.lcywzlzz.com/CN/10.3969/j.issn.1672-3384.2016.06.016 或 http://www.lcywzlzz.com/CN/Y2016/V14/I6/68

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