摘要
目的:探讨临床药师在华法林个体化给药方案制定及实施监护过程中发挥的作用。方法:临床药师采用最大后验贝叶斯估算法制定华法林患者的给药方案,并对方案实施过程进行了监护,及时识别了药物相互作用导致的INR升高,避免了出血不良反应的发生,同时也及时发现了患者漏服药物导致的国际标准化比值(INR)降低,避免了患者再次发生血栓。结果:最大后验贝叶斯估算法可以较好地估算和指导临床用药,对于个体化给药方案具有极大的参考价值。结论:根据基因检测结果选择合适的算法为华法林患者制定了个体化给药方案后,临床药师还需要对整个给药方案实施过程提供全程化的监护,以便及时发现疾病、药物相互作用、依从性不佳等导致的INR异常波动,从而提供抗凝效果,减少出血和栓塞等不良反应。
Objective： To explore the role played by clinical pharmacists in the formulation and pharmaceutical care of individualized administration of warfarin. Methods： Clinical pharmacists adopted maximum a posteriori Bayesian method to formulate the dosage regimen of patients treated with warfarin and monitored the implementation process. The increase of INR was timely identified on account of drug interactions to avoid bleeding events,as well as the decrease of INR caused by patients＇ medication mistakes to avoid recurrence of thrombosis. Results： The maximum a posterior Bayesian estimation method could be used to estimate and guide clinical medication,which showed great reference value for individualized drug regimen. Conclusion： Clinical pharmacists should formulate individualized administration plan according to genetic testing results and choose optimal treatment for patients. Moreover,the implementation of dosage regimen should be monitored during the whole progress,so as to timely find INR abnormal fluctuations due to disease interactions,drug interactions,poor treatment compliance and so on,and consequently improve anticoagulant effect and reduce adverse reactions such as bleeding and thrombosis etc.
出处
《中国药师》
CAS
2018年第3期435-437,共3页
China Pharmacist
基金
福建省科技计划引导性项目(编号:2015Y0020)
关键词
最大后验贝叶斯估算法
华法林
个体化给药
临床药师
药学监护
Maximum a posteriori Bayesian
Warfarin
Individualized administration
Clinical pharmacist
Pharmaceutical care
