A 67-year-old male patient was hospitalized with sudden vague speech and skewed corners of mouth for an hour. After hospitalization, the patient was treated with alteplase 50 mg for thrombolytic therapy, and developed symptomatic hemorrhage transformation and subsequent pulmonary infection. Clinical pharmacists provided rationalization suggestions on blood pressure control, adjustment of antiplatelet drugs, use of traditional Chinese medicine injections and antimicrobials, etc. Considering that the blood pressure of the patients was maintained at 125–130/70 mm Hg in acute phase of cerebral infarction, pharmacist suggested reducing the dosage of mannitol injection in order to increase the brain blood supply. Xueshuantong injection and butylphthalide injection was suggested to stop because of the increased risk of bleeding in combination with antiplatelet drugs and traditional Chinese medicine. Because of the high bleeding risk of cefoperazone and sulbactam, it was replaced by ceftazidime according to the suggestion of clinical pharmacist. After active treatment, bleeding was stopped and infection was controlled. The patient had a clear mind and obviously recovered muscle strength.
Chinese Journal of Drug Application and Monitoring