Bleeding Incidence in Patients Administered with Warfarin at Secondary Hospitals in Yogyakarta Province

被引:0
作者
Ningrum, Vitarani D. A. [1 ]
Sufiyah [2 ]
Widyastuti, Irine Dyah [3 ]
Yusuf, Bacrie Sufriyanto [1 ]
Dullah, Wahyudin [1 ]
机构
[1] Univ Islam Indonesia, Dept Pharm, Sleman 55584, Daerah Istimewa, Indonesia
[2] Sleman Reg Publ Hosp, Sleman 55514, Daerah Istimewa, Indonesia
[3] Bethesda Hosp, Yogyakarta 55224, Daerah Istimewa, Indonesia
来源
INDONESIAN JOURNAL OF PHARMACY | 2020年 / 31卷 / 03期
关键词
Warfarin; Dosage; Bleeding Incidence; Secondary Hospital; ORAL ANTICOAGULANTS; ATRIAL-FIBRILLATION; ANTIPHOSPHOLIPID SYNDROME; ELDERLY-PATIENTS; THERAPY; MANAGEMENT; RISK; AGE; DISEASE; DOSAGE;
D O I
暂无
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Warfarin is an oral anticoagulant most-commonly prescribed for prevention and treatment of thromboembolism. It is widely acknowledged that warfarin has both narrow therapeutic index and various drug-food interactions, thus carrying the risk of subtherapeutic or bleeding. Therefore, warfarin is among the priority drugs to be evaluated to improve the quality of care for warfarin use. This study aimed to analyze the indications and dosage as well as the bleeding incidence in warfarin use at secondary hospitals in Yogyakarta. This research employed the retrospective cross-sectional design among outpatients and inpatients who received warfarin for a minimum of three days. Data of patient demographics, indications and doses of warfarin, incidence of bleeding, and other drugs interacting with warfarin were collected from the medical records for two years of research. The bleeding incidence could include conjunctival bleeding, melena, hematemesis, petechiae, purpura, ecchymosis, or hematochezia as was documented in the medical records. The research involved 139 patients with a majority of male patients and age range of >60 years. The three highest indications of warfarin use were CHF (37.41%), CHF-AF (23.74%), and AF (10.79%) with an average dose of 1.83 +/- 0.54 mg/day. Despite the administration of low doses of warfarin, four patients (2.90%) experienced bleeding with hematuria as the main clinical manifestation. This study recommends adjusting to a lower warfarin dose, particularly for the elderly who receive a combination with aspirin. In addition to a lower maintenance dose, a lower therapeutic target of INR should be further verified for Indonesian patients who receive warfarin.
引用
收藏
页码:217 / 228
页数:12
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