1例瑞舒伐他汀联用缬沙坦致梗阻性黄疸的药学监护

目的 探讨临床药师参与的1例冠心病患者联用瑞舒伐他汀和缬沙坦引起肝损害所致的梗阻性黄疸的药学监护。方法 介绍临床药师参与1例冠心病患者的治疗过程，从药理学角度分析他汀类药物引起的肝损害与剂量、代谢及其他药物相互作用的关系，并提供相关建议。结果 医师只考虑由他汀类药物引起，而临床药师利用专业知识，提出瑞舒伐他汀钙与缬沙坦胶囊的相互作用最大，建议同时停用缬沙坦胶囊。结论 通过医师与药师的合作，从而促进合理用药，保证患者用药的安全有效。同时，也为临床药师实施药学监护提供一种新的思维方式。

Pharmaceutical Care of Obstructive Jaundice Caused by Rosuvastatin Calcium Combined with Valsartan Capsules

OBJECTIVE To explore one case of clinical pharmaceutical care of patient suffered from obstructive jaundice caused by liver damage induced by rosuvastatin calcium combined with valsartan capsule. METHODS The process of clinical pharmacist participating in treatment process for coronary atherosclerotic cardiopathy was introduced, from the perspective of pharmacology, the liver damage leaded by statins and related to pharmacological dose, pharmacokinetics and other statin-induced interactions. Pharmacist provided related recommendations. RESULTS Physicians only considered the liver damage leaded by statins. thinking of the interaction with rosuvastatin calcium and valsartan, clinical pharmacist recommended that valsartan also should be withdrawn. CONCLUSION the cooperation of doctors and pharmacists can improve rationaldrug use, and ensure the medication safety. Simultaneously, the cooperation provides the clinical pharmacists a new way of thinking about the implementation of pharmaceutical care.