Management of anticoagulant therapy in a patient with complex venous thromboembolism complicated with acute renal insufficiency
- VernacularTitle:1例复杂性静脉血栓栓塞症合并急性肾功能不全患者的抗凝药物治疗管理
- Author:
Yongjia HUANG
1
;
Dequan JIANG
2
;
Ling DING
1
;
Jie LIU
1
;
Xiaoyan HE
1
;
Xiaoya LI
1
;
Wanting HUANG
1
;
Jindou LI
2
Author Information
1. Dept. of Pharmacy，Central Hospital of Chongqing Jiangjin District，Chongqing 402260，China
2. Dept. of Gastrointestinal Surgery，Central Hospital of Chongqing Jiangjin District，Chongqing 402260，China
- Publication Type:Journal Article
- Keywords:
venous thromboembolism;
renal insufficiency;
anticoagulant therapy;
genotype;
pharmaceutical monitoring
- From:
China Pharmacy
2023;34(18):2274-2277
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To provide a reference for the safe use of drugs in patients with complex venous thromboembolism （VTE） and acute renal insufficiency. METHODS Clinical pharmacists participated in the management of anticoagulant therapy for a patient with complex VTE complicated with acute renal insufficiency， and evaluated the patient as high-risk thrombosis and bleeding based on their medical history， laboratory test results， etc.； combined with the complexity of thrombosis and renal insufficiency， clinical pharmacists suggested that enoxaparin sodium should be used in the acute stage of thrombosis （5 to 21 days after onset）， and then warfarin should be adopted for oral anticoagulation treatment. Because the patient’s anticoagulation was not up to the standard （the target range of the international normalized ratio was 2-3）， clinical pharmacists suggested increasing the warfarin dose， detecting the warfarin metabolism genotype， and adjusting the warfarin dose according to the genotype； at the same time， clinical pharmacists developed an anticoagulation monitoring plan to ensure the safety of anticoagulation treatment. RESULTS Doctors had adopted all the recommendations of clinical pharmacists. The patient did not experience adverse events such as bleeding or worsening of thromboembolism during anticoagulation in the hospital. When the anticoagulation met the standards， the patient was allowed to be discharged with medication. CONCLUSIONS By participating in the anticoagulation treatment management of patients with complex VTE and acute renal insufficiency， clinical pharmacists have assisted doctors in formulating personalized anticoagulation plans to promote the compliance with the anticoagulation treatment standard and ensure the safety and effectiveness of medication for patients.
