OBJECTIVE: To explore optimization method and effect of clinical pharmacists on anticoagulants therapy plan for cancer patient with venous thromboembolism (VTE). METHODS: Clinical pharmacists participated in the whole process of anticoagulant therapy for one case of breast cancer complicated with VTE. Clinical pharmacists suggested patient to initially take low molecular weight heparin sodium 0.6 ml,sc,qd; and then take Warfarin sodium tablet 3 mg,po,qd; initial plan and oral dosage form plan superimposed and alternated, and pharmaceutical care and medication education were also provided for the patient. RESULTS: Physicians adopted clinical pharmacist’s suggestions, and the patient received anticoagulant therapy for 27 days and paclitaxel chemotherapy once. Coagulation function INR was 2.71; the patient didn’t felt discomfort and then discharged from hospital. CONCLUSIONS: The participation of clinical pharmacists in the optimization of individualized anticoagulant therapy and pharmaceutical care is able to promote rational drug use, prevent severe ADR in the clinic, guarantee the safety of drug use and improve medication compliance.
关键词
乳腺癌静脉血栓栓塞华法林临床药师药学监护
Keywords
Breast cancerVenous thromboembolismWarfarinClinical pharmacistPharmaceutical care