Individualized anticoagulation therapy in cardiology | Personalizēta antikoagulantu terapija kardioloģijā
2010
Urtane, I., Riga Stradins Univ. (Latvia) | Ansabergs, J., Paul Stradins Clinical Univ. Hospital, Riga (Latvia) | Stokmane, A.S., Riga Stradins Univ. (Latvia) | Bandere, D., Riga Stradins Univ. (Latvia)
No standard dosage of warfarin will work for all people or even for the same person in all situations. Dosing of this medication must be individualized. The purpose was to investigate mechanisms of warfarin – drug interactions, identify possible warfarin interactions in the hospital drug prescribing for cardiologic patients. In this study patients from cardiological department of the hospital were included who received warfarin therapy from May 2008 to September 2008. A total of 100 patients (60 male, 40 female) met the study inclusion criteria. The mean age was 69 years. Patients received warfarin treatment for the following indications: atrial fibrillation (43 patients), tachyarrytmia (29 patients), prosthetic valve (7 patients), dilated cardiomyopathy (21 patients). Concomitant other drugs were analysed known either to prolong the prothrombin time or INR or to interact with warfarin. It is recommended that for patients who received combinations of warfarin with other drugs such as amiodarone (25%), anti-inflamatory drugs (aspirin (4%)), statins (13%), proton pump inhibitor (omeprazole (4%)) the daily warfarin dose is reduced to avoid increased bleeding risk. Conclusions: (1) risk of warfarin – drug interactions were found for combined use with amiodarone, digoxin, statins, spironolactone, aspirin, omeprazole, thyroid hormones and antithyroid drugs; (2) physician and clinical pharmacist collaboration is important to recognize, analyze and manage potential warfarin – drug interactions during hospitalizations and if necessary prescribe other medications or adjust dose of warfarin.
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