1例高血压患者服用氨氯地平致水肿的用药分析及监护

Analysis and Monitoring of a Patient with Hypertension Taking Amlodipine-induced Edema

关键词:  高血压  氨氯地平  脚踝水肿  药学监护

Key words:  hypertension  amlodipine  ankle edema  pharmaceutical care

摘要:

目的 为高血压患者安全合理使用氨氯地平提供参考。方法 75岁老年女性高血压患者1例，口服苯磺酸氨氯地平片，每次5 mg，每日2次，血压控制在140/90 mmHg左右。服药4周后，患者双侧踝部水肿开始加重，用药至2个月时，水肿明显加重。患者不能耐受，调整用药方案，苯磺酸氨氯地平片剂量减至每日5 mg，每日早晨8：00左右服用，每晚18：00左右加用缬沙坦胶囊80 mg。结果 联合用药1周后，患者水肿开始减轻，6周后，脚踝水肿完全消退，血压控制良好，无药品不良反应发生。结论 药师应积极参与临床药学实践，关注用药细节和药物相互作用，提高临床药学服务水平和服务能力。

Abstract:

OBJECTIVE To provide references for the management of safe and rational use of amlodipine in patients with hypertension. METHODS A 75-year-old female patient with hypertension, who was given amlodipine besylate tablets, 5 mg each time, twice a day, whose blood pressure was controlled around 140/90 mmHg. Bilateral ankle edema began to aggravate four weeks later, and after two months, the edema was significantly worse. The patient could not tolerate and the medication regimen was adjusted. The dosage of amlodipine was reduced to 5 mg each day, taken at about 8:00, 80 mg valsartan capsules added and given around 18:00 every night. RESULTS After one week, the patient edema began to decrease, and six weeks later, the edema of ankle completely subsided, hypertension was well controlled, and no adverse drug reactions occurred. CONCLUSION Pharmacists should take part in clinical pharmacy practice, focus on medication details and drug interactions, and improve the level and ability of clinical pharmaceutical care.