1.Practice and Experience of Clinical Pharmacist Participating in the Treatment of Nephritic Type NS with Hypertension
Fumei JIAN ; Chun ZHANG ; Wenhong LIN ; Jianfeng LAI
China Pharmacist 2014;(12):2115-2117
Objective: To discuss the entry point of clinical pharmacists for providing pharmaceutical care in clinics. Methods:Clinical pharmacists participated in making drug treatment regimen for one child with nephritic type NS combined with hypertension,and provide pharmaceutical care and medical education for the patient. Results: According to the situation of the patient, the treatment regimen was made out, evaluated and adjusted, and ADR was dealt with in time, therefore, the individualized treatment showed obvious effect, and the child was discharged with an improved condition. Conclusion: Clinical pharmacists can participate in clinical treatment with pharmaceutical professional knowledge to ensure safer and more effective drug use in child patients.
2.Clinical observation of tachycardia-induced cardiomyopathy after radiofrequency cather ablation
Feifei ZHANG ; Xinhui PENG ; Hao YANG ; Fumei HUANG ; Liwei HE ; Wenyuan LAI ; Jian PENG
The Journal of Practical Medicine 2014;(7):1084-1087
Objective To determine the baseline echocardiographic characteristics and the time course and degree of recovery of left ventricular (LV) systolic dysfunction in patients with tachycardia-induced cardiomyopathy ( TCM ) . Methods Seven hundred and fifteen patients received radiofrequency cather ablation ( RFCA ) for tachycardiarrhymias from July 2010 to July 2013 were screened in this study. Only 33 patients with reduced left ventricular ejection fraction (LVEF) (LVEF<50% and improved≥15%) were diagnosed with tachycardia-induced cardiomyopathy and were included in the study. Patients with early improvement (over 25%increase in LVEF at 1-week follow-up compared to the baseline ) were enrolled in the improved group , and the rest patients were enrolled in the improved group. All Patients received transthoracic echocardiography for LV size and function detection at 1 week and at 3,6,12 months follow-up. Results The average baseline of the LV end-diastolic diameter, and the LVEF were (55 ± 10.7)mm and (38 ± 4.6)%, repectively. Early improvement ( over 25%increase in LVEF at 1-week follow-up compared to the baseline ) in the improved group was observed in 16 patients. Patients with early improvement had higher LVEF at 12-month follow-up compared to the patients without early improvement [(69.2± 4.2)% vs (58.1 ± 6.9)%, P < 0.001]. Conclusions RFCA is proved to be a relatively safe and effecient treatment method. Atrial fibrillation related to TCM , rhythm control is superior to the rate control. The early improvement in LVEF may potentially predict the complete reversibility of LV systolic dysfunction.
3.Clinical outcomes of bridging therapy with fondaparinux versus low-molecular-weight heparin in patients undergoing atrial fibrillation ablation.
Feifei ZHANG ; Donghua ZHAO ; Xinhui PENG ; Hao YANG ; Tingyan ZHU ; Fumei HUANG ; Jian PENG
Journal of Southern Medical University 2014;34(4):448-452
OBJECTIVETo compare the efficacy and safety of bridging therapy with fondaparinux versus low-molecular-weight heparin (LMWH) in patients undergoing radiofrequency ablation for atrial fibrillation (AF).
METHODSAF patients undergoing radiofrequency ablation between January, 2009 and June, 2013 in Nanfang Hospital were analyzed. The patients received subcutaneous injection of either fondaparinux or LMWH as a bridging therapy during warfarin discontinuation 5 days before the ablation until a post-ablation international normalized ratio (INR) of 2.0-3.0 was achieved. Anticoagulant-related complications, identified and classified as thromboembolic and bleeding events, were compared between the two groups.
RESULTSA total of 465 patients (68% male; mean age 52.3∓15 years, range 25 to 80 years) were enrolled in the study, including 265 in fondaparinux group and 200 in LMWH group. Anticoagulation-related complications were observed in 3 patients in fondaparinux group, as compared with 13 in LMWH group (P=0.002), but the thromboembolic rate did not differ significantly between the two groups (P=0.111). Two patients in fondaparinux group and 8 in LMWH group showed bleeding complications (P=0.039). No cardiovascular death occurred in these patients during a mean follow-up period of 3 months.
CONCLUSIONSFondaparinux as the bridging therapy during catheter ablation for AF does not increase the risk of thromboembolic complications but slightly reduces the risk of bleeding compared to LMWH, suggesting its safety and effectiveness for periprocedural anticoagulation management in AF patients undergoing radiofrequency ablation.
Adult ; Aged ; Aged, 80 and over ; Anticoagulants ; therapeutic use ; Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Female ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Male ; Middle Aged ; Polysaccharides ; therapeutic use