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）