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临床药师参与经母口服地高辛治疗胎儿心动过速的药物治疗管理实践
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| 篇名： | 临床药师参与经母口服地高辛治疗胎儿心动过速的药物治疗管理实践 |
| TITLE： | Participation of Clinical Pharmacists in the Management of Drug Therapy for Fetal Tachycardia Treated by Oral Administration of Digoxin through Mother |
| 摘要： | 目的：探讨临床药师在经母口服地高辛治疗胎儿心动过速治疗过程中的作用。方法：临床药师参与1例胎儿心动过速孕妇的治疗全过程。根据患者妊娠31+6周、入院时胎心率230次/min的情况，临床药师针对经母口服地高辛治疗胎儿心动过速的安全性和血药浓度测定等问题向医师提出相关建议。因患者血钾值偏低，建议应用地高辛前先补钾，并建议地高辛的初始剂量为每12h给药0.5mg；在院7天时，患者地高辛血药浓度值升高明显，临床药师建议调整地高辛剂量至维持剂量（每12h给药0.25mg）；在院11天时患者血钠值偏低，临床药师对其进行饮食指导；同时，临床药师向医、护、患交代地高辛不良反应的表现，对患者密切观察并进行用药宣教。结果：医师对临床药师的建议均采纳。患者于治疗13天后出院，出院时胎心率降至180次/min，母体地高辛血药浓度维持平稳，母胎均未发生药物不良反应。结论：妊娠期患者用药应兼顾母胎安全；临床药师协助医师制订用药策略、对患者进行药学监护和宣教，保障了胎儿心动过速治疗用药的有效性和安全性。 |
| ABSTRACT： | OBJECTIVE：To investigate the ro le of clinical pharmacists in the therapy of fetal tachycardia by oral administration of digoxin through mother. METHODS ：The clinical pharmacists participated in the whole process of drug therapy for a pregnant woman with fetal tachycardia. According to 31+6 weeks of gestation ，the fetal heart rate of 230 beats/min at admission，clinical pharmacists provided the suggestion for the doctor about the safety and blood concentration determination of digoxin in the treatment of fetal tachycardia by mother. The patient ’s blood potassium value was lower than the normal range ，and it was suggested that potassium should be supplemented before digoxin was used ，and the initial dose of digoxin was 0.5 mg per 12 h. On the 7th day in the hospital ，the dosage of digoxin should be adjusted to maintaining dose （0.25 mg per 12 h）；on the 11th day in the hospital ，the patient ’s blood sodium value was low ，and the clinical pharmacists gave diet guidance. At the same time ， the clinical pharmacists explained the adverse reactions of digoxin to the doctors ，nurses and patients ，and closely observed and educated the patients. RESULTS ：Doctors adopted the suggestions of the clinical pharmacists. The fetal heart rate decreased to 180 beats/min from hospital after 13 days of treatment. The maternal digoxin concentration remained stable. No adverse drug reactions occurred in the mother and infant. CONCLUSIONS ：Maternal and child safety should be taken into account in the medication of pregnant patients. The clinical pharmacists assisting doctors to formulate medication strategying ，and carrying out pharmaceutical care for patients ，can ensure the effectiveness and safety of medication for fetal tachycardia. |
| 期刊： | 2021年第32卷第05期 |
| 作者： | 梅洪梁，张海霞，张玲，张晋萍 |
| AUTHORS： | MEI Hongliang，ZHANG Haixia，ZHANG Ling，ZHANG Jinping |
| 关键字： | 宫内治疗；胎儿心动过速；地高辛；药学监护；临床药师 |
| KEYWORDS： | Intrauterine treatment ；Fetal tachycardia ；Digoxin；Pharmaceutical care ；Clinical pharmacist |
| 阅读数： | 425 次 |
| 本月下载数： | 22 次 |
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