抗凝专业药师参与1例华法林抵抗的肺栓塞患者用药方案制订

摘要

目的：：抗凝专业的临床药师参与制订华法林抵抗患者治疗方案。方法：针对1例华法林抵抗的肺栓塞患者进行原因分析，提供华法林用药方案。结果：该华法林抵抗患者通过基因检测明确基因型为VKORC1-1639AG型，排除其他原因，确定为遗传性华法林抵抗，药师协助制订了用药方案，使患者INR值达标。结论：针对华法林抵抗的患者，首先明确华法林抵抗的原因，制定相应的治疗策略，基因检测对于华法林抵抗的患者不失为一种重要手段。%Objective: To discuss the therapeutic regimen for warfarin resistant patients with the help of clinical pharmacists. Methods:The pharmacist analyzed the cause of warfarin resistance and provided the dose adjustment for a pulmonary embolism pa-tient. Results:The genotype of the patient was identified as VKORC1-1639AG by gene test. The patient was diagnosed as hereditary warfarin resistance excluding other causes. With the assistance of pharmacist, the problem of warfarin resistant was solved. Conclu-sion:For warfarin resistant patients, clinical pharmacists must definite the reason of warfarin resistant firstly and then carry out the therapeutic strategy. Gene detection may be used as an important guide for warfarin resistance.