Authors :
K. Bharathi Priya; Shoba S P; Charanya A G; Bhuvaneshwari B; Sneha V
Volume/Issue :
Volume 9 - 2024, Issue 12 - December
Google Scholar :
https://tinyurl.com/yf8mn92e
Scribd :
https://tinyurl.com/mrxyypff
DOI :
https://doi.org/ 10.5281/zenodo. 14564975
Abstract :
Purpose:
Anticoagulants are administered for various
vascular conditions; there is always a risk of bleeding with
this class of drug. It is essential to monitor the
prothrombin time and International Normalisation Ratio
(INR) values to prevent side effects.
Objective:
Drug utilization evaluation of anticoagulants and to
monitor outcomes of drug therapy.
Methodology:
A prospective cohort study carried out on 140
patients with cardiac complications who were on
anticoagulant therapy. We collected all necessary data
from the patient's case sheets, lab reports, and treatment
charts. Patients were continuously monitored for the
effectiveness of treatment, and any adverse effects on
anticoagulant usage were monitored.
Results:
68% of the study population were males with cardiac
problems who were treated with anticoagulants. As the
age increases, the occurrence of cardiovascular events
also increases. Enoxaparin (Clexane) (72%), at doses of
4000 IU or 6000 IU, was the majorly prescribed drug. The
majority of the patients were in the safe zone with no risk
of clotting or bleeding. A significant number had a risk of
developing clots, and very few had the risk of bleeding.
Minor ADRs like bruising and swelling were identified.
Conclusion:
Harmful drug-related reactions such as bruising,
abdominal pain, swelling, and haematuria were observed
after the anticoagulant therapy was initiated. Continuous
monitoring has definitely reduced the incidence of
adverse effects in connection with the administration of
anticoagulant therapy.
Keywords :
Heparin, Anticoagulants, Blood Clots, Cardiovascular Disease, Drug Utilization Pattern, Adverse Drug Reaction (ADR), Pharmacovigilance.
References :
- Onishi A, St Ange K, Dordick JS, Linhardt RJ (2016) Heparin and anticoagulation. Front Biosci (Landmark Ed). 1;21(7):1372-92. doi: 10.2741/4462.
- Seaman S, Nelson A, Noble S. (2014) Cancer-associated thrombosis, low-molecular-weight heparin, and the patient experience: a qualitative study. Patient Prefer Adherence. 8;8:453-61. doi: 10.2147/PPA.S58595.
- Lee S, Han J, Park RW, Kim GJ, Rim JH, Cho J, Lee KH, Lee J, Kim S, Kim JH (2019) Development of a Controlled Vocabulary-Based Adverse Drug Reaction Signal Dictionary for Multicenter Electronic Health Record-Based Pharmacovigilance. Drug Saf. 42(5):657-670. doi: 10.1007/s40264-018-0767-7.
- Zaidi SRH, Rout P (2024) Interpretation of Blood Clotting Studies and Values (PT, PTT, aPTT, INR, Anti-Factor Xa, D-Dimer) [Updated 2024 Jun 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.https://www.ncbi.nlm.nih.gov/books/NBK604215/
- Shikdar S, Vashisht R, Bhattacharya PT (2024) International Normalized Ratio (INR) [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK507707/
- Cannegieter SC, Rosendaal FR, Wintzen AR, van der Meer FJ, Vandenbroucke JP, Briët E (1995) Optimal oral anticoagulant therapy in patients with mechanical heart valves. N Engl J Med. 6;333(1):11-7. doi: 10.1056/NEJM199507063330103.
- Harine G, Bharathi Priya K, Pavithra A, Jayakumar D, Farazuddin M, Tejaswini S (2023) A Comparative Study on Caprini RAM Vs DOH Tool for Thromboprophylaxis in ICU Setting at Tertiary Care Hospital. J. Drug Delivery Ther. 13(9):55-1. https://jddtonline.info/index.php/jddt/article/view/6198
- Amaraneni A, Chippa V, Goldin J, et al (2024) Anticoagulation Safety. [Updated 2024 Oct 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519025/
- Khan MA, Hashim MJ, Mustafa H, Baniyas MY, Al Suwaidi SKBM, AlKatheeri R, Alblooshi FMK, Almatrooshi MEAH, Alzaabi MEH, Al Darmaki RS, Lootah SNAH (2020) Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study. Cureus. 23;12(7): e9349. doi: 10.7759/cureus.9349.
- Alzubaidi N, Sharma M, Abdulmalik W, Habib A, Alhalmi A (2019) Drug Utilization Study and Adverse Drug Reaction Reporting among Patients Using Anticoagulants in a Tertiary Care Teaching Hospital. J. Drug Delivery Ther. 9(3-s):181-5. https://jddtonline.info/index.php/jddt/article/view/2820
- Shivashankar. V, Arathi. C, Ashly Maria Mathew, Atchaya. P, Deepika. R (2022) Drug Utilization and Evaluation of Anticoagulant and Anti-Platelet Drugs and Assessing Their Safety in Preventing Cardiovascular Diseases. Ijppr.Human. 25 (4): 682-696. https://ijppr.humanjournals.com/wp-content/uploads/2022/12/41
- Tang N, Chen S, Shi X, Ye Z, Zheng X (2015) Effect of enoxaparin on clinical events after percutaneous coronary intervention. Int J Clin Exp Med. 15;8(7):10815-24.
- Janardan J, Gibbs H (2018) Combining anticoagulation and antiplatelet drugs in coronary artery disease. Aust Prescr. 41(4):111-115. doi: 10.18773/austprescr.2018.039.
- Barnes GD (2020) Combining antiplatelet and anticoagulant therapy in cardiovascular disease. Hematology Am Soc Hematol Educ Program. (1):642-648. doi: 10.1182/hematology.2020000151.
- Kassere S, Kalra J, Rawat A, & Kohli S (2019) Adverse drug reactions monitoring of anticoagulant drugs used in cardiac coronary care unit of a tertiary care hospital. International Journal of Basic & Clinical Pharmacology, 8(11), 2512–2516. https://doi.org/10.18203/2319-2003.ijbcp2019479.
Purpose:
Anticoagulants are administered for various
vascular conditions; there is always a risk of bleeding with
this class of drug. It is essential to monitor the
prothrombin time and International Normalisation Ratio
(INR) values to prevent side effects.
Objective:
Drug utilization evaluation of anticoagulants and to
monitor outcomes of drug therapy.
Methodology:
A prospective cohort study carried out on 140
patients with cardiac complications who were on
anticoagulant therapy. We collected all necessary data
from the patient's case sheets, lab reports, and treatment
charts. Patients were continuously monitored for the
effectiveness of treatment, and any adverse effects on
anticoagulant usage were monitored.
Results:
68% of the study population were males with cardiac
problems who were treated with anticoagulants. As the
age increases, the occurrence of cardiovascular events
also increases. Enoxaparin (Clexane) (72%), at doses of
4000 IU or 6000 IU, was the majorly prescribed drug. The
majority of the patients were in the safe zone with no risk
of clotting or bleeding. A significant number had a risk of
developing clots, and very few had the risk of bleeding.
Minor ADRs like bruising and swelling were identified.
Conclusion:
Harmful drug-related reactions such as bruising,
abdominal pain, swelling, and haematuria were observed
after the anticoagulant therapy was initiated. Continuous
monitoring has definitely reduced the incidence of
adverse effects in connection with the administration of
anticoagulant therapy.
Keywords :
Heparin, Anticoagulants, Blood Clots, Cardiovascular Disease, Drug Utilization Pattern, Adverse Drug Reaction (ADR), Pharmacovigilance.