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目的临床药师利用专业知识,对1例患者停华法林药后国际标准化比值(INR)异常升高进行药学服务。方法临床药师根据患者的临床情况、用药史,结合患者基因检测为医师提出治疗建议。结果患者经合理处置后INR恢复至安全范围,经行基因检测指导华法林用药,患者达标出院。结论临床药师可综合专业知识和最新技术进展积极参与临床药物治疗实践,促进患者用药安全有效。
Objectives The clinical pharmacists use their expertise to conduct pharmacy services on an abnormal increase in the international normalized ratio (INR) of Haloxifen in one patient. Methods Clinical pharmacists proposed the treatment for the physician based on the patient’s clinical situation, medication history, combined with the patient’s genetic testing. Results The patients recovered to a safe range after reasonable disposal, and warfarin medication was guided by genetic testing and the patients were discharged to the standard. Conclusion Clinical pharmacists can actively participate in the practice of clinical drug treatment based on comprehensive professional knowledge and the latest technological progress, and promote the safe and effective use of drugs in patients.