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臨床藥學大觀園

《論藥之道》

直接口服抗凝血劑應依腎功能調整劑量(下)

 

◎文╱趙凡琇

 

處方評估(續)


3. 疑義說明:


病人為新診斷之心房顫動病人,CHA2DS2-VASc為3分,醫師選用rivaroxaban 20 mg QDCC預防中風與全身性栓塞風險,因病人CCr 33 mL/min,須依腎功能調整劑量至15 mg QDCC。


檢驗項目參考值:


BUN (blood urea nitrogen): 7-20 mg/dL; SCr (serum creatinine): male: 0.7-1.5 mg/dL; female: 0.5-1.2 mg/dL; CCr (Creatinine clearance rate): >60 mL/min; ALT (alanine aminotransferase): 0-40 U/L; AST (aspartate aminotransferase): 5-45 U/L


(全文完)


參考資料


1. Steffel J, Verhamme P, Potpara T, et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Eur Heart J 2018;39:1330-93.
2. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS Guideline for the management of patients with atrial fibrillation: Executive summary. J Am Coll Cardio 2014;64:2246-80.
3. January CT, Wann LS, Alpert JS, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons. Circulation 2019;140:e125-51.


(本文作者為臺北榮民總醫院藥學部臨床藥師/美國北卡羅萊納州Campbell大學PharmD)

 

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