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目的:通过临床药师参与华法林给药方案的设计,探讨华法林个体化给药的合理方式。方法:临床药师参与1例华法林抗凝过度致肾损伤患者的用药方案的优化和药学监护。结果:确定符合患者特点华法林个体化用药方案,患者病情得到缓解,用药依从性提高。结论:临床药师参与个体化给药过程,有利于增强临床药物治疗效果和发挥临床药师的作用。
OBJECTIVE: To investigate the rational ways of individualized administration of warfarin through clinical pharmacists’ participation in the design of warfarin dosage regimen. Methods: Clinical pharmacists participated in the optimization of the regimen and pharmacy care of 1 warfarin in patients with renal injury caused by hypercoagulable anticoagulation. Results: To determine the characteristics of patients with warfarin individualized medication program, the patient’s condition has been alleviated, medication compliance increased. Conclusion: The participation of clinical pharmacists in the process of individualized administration is conducive to enhancing the effect of clinical drug treatment and playing the role of clinical pharmacist.