Pharmaceutical care in a patient with hemorrhagic transformation after cerebral infarction complicated with atrial fibrillation
- VernacularTitle:1例脑梗死出血转化合并心房颤动患者的药学监护
- Author:
Ling GAO
1
;
Jing YUAN
2
;
Wenjie QIN
3
;
Bin ZHU
4
;
Xianzhou LI
5
;
Jiao QIAN
6
Author Information
1. Dept. of Pharmacy，the First Affiliated Hospital of Naval Medical University，Shanghai 200433，China;Dept. of Pharmacy，the 71st Group Army Hospital of PLA，Jiangsu Xuzhou 221004，China
2. Dept. of Pediatrics，the First Affiliated Hospital of Naval Medical University，Shanghai 200433，China
3. Dept. of Pharmacy，the First Affiliated Hospital of Naval Medical University，Shanghai 200433，China;Dept. of Pharmacy，Hunan Provincial People’s Hospital，Changsha 410005，China
4. Dept. of Pharmacy，the 71st Group Army Hospital of PLA，Jiangsu Xuzhou 221004，China
5. Dept. of Pharmacy，the First Affiliated Hospital of Naval Medical University，Shanghai 200433，China;Dept. of Pharmacy，the 990 Hospital of Joint Logistics Support Force，Henan Zhumadian 463000，China
6. Dept. of Pharmacy，the First Affiliated Hospital of Naval Medical University，Shanghai 200433，China
- Publication Type:Journal Article
- Keywords:
hemorrhagic transformation after cerebral infarction;
atrial fibrillation;
anticoagulant restart;
pharmaceutical
- From:
China Pharmacy
2024;35(24):3071-3075
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To provide a reference for pharmaceutical care in patients with hemorrhagic transformation after cerebral infarction complicated with atrial fibrillation. METHODS Clinical pharmacists participated in the treatment practice of a patient with hemorrhagic transformation after cerebral infarction complicated with atrial fibrillation. Because the patient had a hemorrhagic transformation after cerebral infarction after stent implantation and arterial thrombolysis， the clinical pharmacists recommended stopping antiplatelet drugs and giving plasma and cold precipitation； because D-dimer was significantly elevated， the clinical pharmacists recommended anticoagulant therapy with low-molecular heparin. Due to the patient’s recurrence of hemorrhagic transformation after cerebral infarction， the clinical pharmacists recommended discontinuing rivaroxaban and administering human prothrombin complex concentrate. RESULTS The physician adopted the clinical pharmacists’ recommendation. After treatment， the patient’s condition tended to improve steadily and was allowed to be discharged with medication. CONCLUSIONS The clinical pharmacists assessed the individualized risk and optimized the patient’s medication regimen by suggesting discontinuation of antiplatelet and anticoagulant drugs， carrying out pharmaceutical care such as coagulation index monitoring， determining the time and indications for restarting anticoagulation， and pharmaceutical monitoring， to ensure the safety and efficacy of the patient’s medication.
