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OBJECTIVE: To provide reference for the teaching level in clinical pharmacy teaching in China.METHODS: In a case of consultation on a severe heart failure patient with diuretic resistance, teachers proposed heuristic problems, clinical pharmacist students performed the literature search based on problems and specific circumstances of the patient, then students and teachers made clinical consultation together.PBL method was adopted to observe the effect of teaching.RESULTS: The patient was a severe heart failure patient with low sodium, tendency of deterioration of kidney function and diuretic resistance.The students and teachers made consultation by PBL method, the patient was recommend the use of vasopressin receptor antagonists, after the use of the drug, heart failure symptom was under control, the patient was getting better, proven effective clinically.CONCLUSIONS: Heart failure has complex clinical symptoms,diuretics is the only drug which can control or eliminate fluid retention effectively for patients with fluid retention, but diuretics resistance greatly increased the risk of sudden death or death caused by pump failure, so how to choose the diuretics and how to deal with diuretic resistance for patients with heart failure, especially in patients with acute heart failure or severe heart failure, has important clinical significance.Application of PBL method in clinical pharmacy teaching sharpen to understand of diuretic resistance strategy, strengthen the teaching effects and foster the students'ability to study on their own and the ability of comprehensive thinking, which can elevate both quality of teaching and students' quality.