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1、腎移植高血壓患者藥學(xué)監(jiān)護(hù)胡永芳MajorContentsCauseofhypertensionintherenaltransplantationTreatmentofhypertensionintherenaltransplantrecipientAnti-hypertensionmedicationsCaseStudyPatientdetails(renaltransplantation)Number:4438420Sex:MaleWeight:63kgHigh:160cmDateofBirth:1943/02/09Age:63yearsDisease
2、:ChronicnephritisOperationdate:2006/04/19CadavericColdischemiatime(hours):12Heatischemiatime(minutes):5CurrentmedicationImmunosuppressiveregimentsCyclosporine100mgBid125mgBidALG250mgQDMizoribine100mgQD,50mgQNMycophenolatemofetil750mgBidMethylprednisolone500mgQd3dPrednisolone30mgQ
3、dCurrentanti-hypertensivemedicationsMetoprolol12.5mgQ12hNifedipineControlledreleased30mgqd30mgQ12hEnalapril10mgQ12hFurosemide40mgtid40mgqd172/89患者醫(yī)師藥劑師護(hù)士MedicalCareNursingCareDrugInformation?。harmaceuticalCareInformationDrugInformation?。harmaceuticalCareInformation以患者為中心、以人為本Ph
4、armaceuticalCarePharmaceuticalcareandpatientassessmentInitiaterelationshipwithpatientGatherpatientinformation(subjectiveandobjective)Assessinformation(patientassess)CompletetheinterventionDeveloppharmaceuticalcareplanImplementfollow-upGraftandpatientsurvivalKaplan–Meieranalyseswi
5、ththepopulationdividedintoquintilesofsystolicBPTutoneVK,etal.ClinTransplant2005:19:181–192.GraftandpatientsurvivalKaplan–Meieranalyseswiththepopulation dividedintoquintilesofdiastolicBPTutoneVK,etal.ClinTransplant2005:19:181–192.Summaryofanti-hypertensiveswithpatientandgraftoutco
6、mesBB,beta-blocker;CC,calciumchannelblocker;Loop,loopdiuretic;ACEI,angiotensinconvertingenzymeinhibitor;ARB,angiotensinreceptorantagonistDiagnosisandtreatmentofhypertensionintherenaltransplantrecipientContinueanti-hypertensivetherapyReassessperiodicallyAdministeranti-hypertensive
7、Agent(CA,ACEI,orotherBloodpressure>=140/90StableGFR?InterventionfailstonormalizeBPConsidersaltrestrictionand/ordiureticMultidrugregimen;addagentsofdifferentclassesasnecessaryReducedoseofcyclosporineortacrolimusEvaluateallograftfunctionOptimalbloodlevelsofcyclosporineortacrolimusE
8、CGvolumestatusacceptable?Adequaterespons
