2例高血压合并糖尿病患者的药学监护

目的探讨药师对使用心脑血管病药品的老年患者在服药时间方面进行合理安排的意义。方法对2例高血压伴糖尿病老年患者联合使用的非洛地平缓释片、缬沙坦胶囊、乐卡地平片、阿司匹林肠溶片和酒石酸美托洛尔片等药物的医嘱审核,查阅相关资料,协助医师制订个体化给药方案。结果非洛地平缓释片和酒石酸美托洛尔片,乐卡地平片改为早晨空腹给药,避免食物对药物生物利用度的影响,提高药物作用强度的稳定性,建议老年患者尽可能进行24h动态血压监测,合理安排降压药给药时间。阿司匹林肠溶片改为餐前口服,避免胃肠道黏膜损伤。结论药师应加强对给药方案细节的关注,从而有助于合理使用药品,减少不良反应的发生。

Pharmaceutical care of two patients with hypertension combined with diabetes mellitus

Objective To explore the significance of pharmacists’reasonable arrangement of medication time for elderly patients with cardiovascular and cerebrovascular diseases.Methods To review the orders of two elderly patients with hypertension combined with diabetes using felodipine sustained-release tablets,valsartan capsules,lekadipine tablets,aspirin enteric coated tablets and metoprolol tablets,consult the relevant information,and assist the doctors to formulate individualized drugs.Results Felodipine sustained release tablets,metoprolol tartrate tablets and locardipine tablets were given on an empty stomach in the morning to avoid the effect of food on the bioavailability of drugs and to improve the intensity and stability of drug action.It was suggested that elderly patients should have 24-hour dynamic blood pressure monitoring as far as possible and reasonably arrange the administration time of antihypertensive drugs.A spirin entericcoated tablets should be given before meals to avoid gastrointestinal mucosal damage.Conclusion Pharmacists should pay more attention to the details of drug administration plan,which was helpful for rational use of drugs and reducing the occurrence of adverse reactions.