肾移植高血压患者药学监护ppt课件

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1、肾移植高血压患者药学监护胡永芳MajorContentsCauseofhypertensionintherenaltransplantationTreatmentofhypertensionintherenaltransplantrecipientAnti-hypertensionmedicationsCaseStudyPatientdetails(renaltransplantation)Number:4438420Sex:MaleWeight:63kgHigh:160cmDateofBirth:1943/02/

2、09Age:63yearsDisease:ChronicnephritisOperationdate:2006/04/19CadavericColdischemiatime(hours):12Heatischemiatime(minutes):5CurrentmedicationImmunosuppressiveregimentsCyclosporine100mgBid125mgBidALG250mgQDMizoribine100mgQD,50mgQNMycophenolatemofetil750mgBidMeth

3、ylprednisolone500mgQd3dPrednisolone30mgQdCurrentanti-hypertensivemedicationsMetoprolol12.5mgQ12hNifedipineControlledreleased30mgqd30mgQ12hEnalapril10mgQ12hFurosemide40mgtid40mgqd172/89患者医师药剂师护士MedicalCareNursingCareDrugInformation　＆PharmaceuticalCareInformatio

4、nDrugInformation　＆PharmaceuticalCareInformation以患者为中心、以人为本PharmaceuticalCarePharmaceuticalcareandpatientassessmentInitiaterelationshipwithpatientGatherpatientinformation(subjectiveandobjective)Assessinformation(patientassess)CompletetheinterventionDeveloppharm

5、aceuticalcareplanImplementfollow-upGraftandpatientsurvivalKaplan–MeieranalyseswiththepopulationdividedintoquintilesofsystolicBPTutoneVK,etal.ClinTransplant2005:19:181–192.GraftandpatientsurvivalKaplan–Meieranalyseswiththepopulationdividedintoquintilesofdiasto

6、licBPTutoneVK,etal.ClinTransplant2005:19:181–192.Summaryofanti-hypertensiveswithpatientandgraftoutcomesBB,beta-blocker;CC,calciumchannelblocker;Loop,loopdiuretic;ACEI,angiotensinconvertingenzymeinhibitor;ARB,angiotensinreceptorantagonistDiagnosisandtreatmentof

7、hypertensionintherenaltransplantrecipientContinueanti-hypertensivetherapyReassessperiodicallyAdministeranti-hypertensiveAgent(CA,ACEI,orotherBloodpressure>=140/90StableGFR?InterventionfailstonormalizeBPConsidersaltrestrictionand/ordiureticMultidrugregimen;adda

8、gentsofdifferentclassesasnecessaryReducedoseofcyclosporineortacrolimusEvaluateallograftfunctionOptimalbloodlevelsofcyclosporineortacrolimusECGvolumestatusacceptable?Adequaterespons