急性 ST 段抬高型心肌梗死的药物治疗和药剂师的角色,第二部分:并发症、血管重建后护理和质量改进。

IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY American Journal of Health-System Pharmacy Pub Date : 2024-10-25 DOI:10.1093/ajhp/zxae310
Sara J Hyland, Marion E Max, Rachael E Eaton, Stephanie A Wong, Susan B Egbert, Danielle M Blais
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引用次数: 0

摘要

免责声明:为了加快文章的发表,AJHP在接受稿件后会尽快将其发布到网上。被录用的稿件已经过同行评审和校对,但在进行技术格式化和作者校对之前会在网上发布。目的:回顾ST段抬高型心肌梗死(STEMI)患者在住院治疗后期的主要药物治疗方式和注意事项。摘要:已发表的关于临床药师在STEMI急性期管理中的作用的描述和验证非常有限。从发病到血管再通、病情稳定和出院的这一高风险时期涉及复杂的药物治疗决策点、众多的操作用药需求和多层次的质量监督。另一篇文章回顾了从急诊科就诊到血管重建的 STEMI 药物治疗。在此,我们完成了 STEMI 患者在住院治疗阶段的药物治疗回顾,包括使用血管活性药物和抗心律失常药物治疗梗死周围并发症、血管再通后抗血栓药物的注意事项以及支持疗法和二级预防的评估。从临床药剂师的角度总结了主要指南建议和文献发展,并提出了药剂师的角色和职责。此外,还提供了 STEMI 后成功出院的注意事项以及药剂师参与相关机构质量改进工作的情况。我们的目标是支持住院药学部门推进对这一重要患者群体的临床服务,并呼吁进一步研究药剂师对患者和医疗机构 STEMI 治疗效果的影响。
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Pharmacotherapy of acute ST-elevation myocardial infarction and the pharmacist's role, part 2: Complications, postrevascularization care, and quality improvement.

Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Purpose: Key pharmacotherapeutic modalities and considerations for the patient with ST-elevation myocardial infarction (STEMI) across the later phases of inpatient care are reviewed.

Summary: Published descriptions and validation of clinical pharmacist roles specific to the acute management of STEMI are limited. This high-risk period from presentation through revascularization, stabilization, and hospital discharge involves complex pharmacotherapeutic decision points, many operational medication needs, and multiple layers of quality oversight. A companion article reviewed STEMI pharmacotherapy from emergency department presentation through revascularization. Herein we complete the pharmacotherapy review for the STEMI patient across the inpatient phases of care, including the management of peri-infarction complications with vasoactive and antiarrhythmic agents, considerations for postrevascularization antithrombotics, and assessments of supportive therapies and secondary prevention. Key guideline recommendations and literature developments are summarized from the clinical pharmacist's perspective alongside suggested pharmacist roles and responsibilities. Considerations for successful hospital discharge after STEMI and pharmacist involvement in associated institutional quality improvement efforts are also provided. We aim to support inpatient pharmacy departments in advancing clinical services for this critical patient population and call for further research delineating pharmacists' impact on patient and institutional STEMI outcomes.

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来源期刊
CiteScore
2.90
自引率
18.50%
发文量
341
审稿时长
3-8 weeks
期刊介绍: The American Journal of Health-System Pharmacy (AJHP) is the official publication of the American Society of Health-System Pharmacists (ASHP). It publishes peer-reviewed scientific papers on contemporary drug therapy and pharmacy practice innovations in hospitals and health systems. With a circulation of more than 43,000, AJHP is the most widely recognized and respected clinical pharmacy journal in the world.
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