ABSTRACT
Objective: The aim of the present study was to assess the prevalence, risk rating and the severity of hazardous pDDIs (potential drug-drug interactions) in the prescribed pharmacotherapy in the hospital discharged heart failure (HF) patients, primarily with co-administered drugs with narrow therapeutic index (statins, anticoagulants, antithrombotic drugs). Methods: The prescriptions of chronic heart failure patients for one year (January-December 2014) were analyzed for pDDIs through Lexi-interact® software. DDIs belonging to the categories D (Consider therapy modification) and X (Avoid combination) and/or severity of drug interaction-major, were selected for the study. Results: After reviewing the medical records of 985 patients, 239 patients were selected based on the criteria mentioned above. The average number of prescription drugs at hospital discharge was 7.27 medications (±1.84 SD) per patient. The total number of pDDIs was 1483 or approximately 6.2 (±3.89 SD) pDDIs per patient. With respect to the risk rating, in categories D and X were detected 76 (5.12 %) and 2 (0.13 %) pDDI, respectively. The major pDDIs were 108 (7.28 %). Conclusion: HF patients are at high risk of pDDIs. Screening of prescriptions for pDDIs and monitoring of pharmacotherapy in terms of response and associated adverse drug events will contribute to patient safety.
ABSTRACT
Objective:To discuss the application of antithrombotic drugs in myocardial infarction patients with thrombocytopenia. Methods:The therapy for one myocardial infarction patient with primary thrombocytopenia was discussed and summarized. Based on the related literatures, the characteristics of case, application status and adverse reactions of antithrombotic drugs and anticoagulant drugs were summarized. Results: The adjustment of antithrombotic drug treatment regimen for the patient was reasonable. Conclu-sion:Antithrombotic drugs applied in acute myocardial infarction patients with thrombocytopenia are safe. If patients complicate with other diseases, individualized antithrombotic therapy should be carried out according to particular case.
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Objective:To observe the effect of stereotactic aspiration combined with corresponding drug therapy in the treatment of cerebral hemorrhage induced by different drugs. Methods:Totally 66 patients with hemorrhage induced by antithrombotic drugs were randomly divided into the control group and the treatment group with 33 cases in each. The control group was given corresponding drug therapy according to the pathogenesis of cerebral hemorrhage, and the treatment group was treated by stereotactic hematoma aspiration additionally. Daily life ability, NIHSS and prognosis improvement were compared between the two groups before and after the treat-ment. Results:After the treatment, NIHSS of the treatment group was ( 10. 17 ± 2. 97 ) and Barthel index score was ( 59. 97 ± 12. 10), which were both better than those of the control group (P<0. 05). The prognosis of the treatment group was also better than that of the control group (P<0. 05). There was no severe adverse drug reaction in the two groups. Conclusion:For different drug in-duced cerebral hemorrhage, corresponding drug therapy should be carried out, and combining with stereotactic hematoma aspiration, the therapeutic regimen can effectively improve neurological deficits and activities of daily living of the patients, and then improve the prognosis of the patients with promising safety.
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Objective:To guide antithrombotic medication in the patients with PCI by GRACE and CRUSADE risk score. Meth-ods:The GRACE and CRUSADE score at the admission of 147 patients with ACS undergone PCI in one 3-level hospital were analyzed, and the two risk scores of the PCI patients and the correlation between the two scores were studied. Results:The risk factors in the two scores were part of the same, and the two scores had significant positive correlation. Conclusion: The GRACE score and CRUSADE score should be assessed at the same time in clinics to weigh the risk of bleeding and ischemia fully and then develop strategies for an-tithrombotic treatment.
ABSTRACT
La fibrilación auricular no valvular (FANV) es la arritmia cardíaca sostenida más frecuente. El accidente cerebrovascular (ACV) asociado a la (FANV), es una complicación devastadora, prevenible, con secuelas neurológicas, recurrencias, mortalidad precoz y al año mayor que el (ACV) no asociado a la (FANV). La warfarina demostró en prevención primaria una reducción del riesgo de 64%. El presente trabajo aborda nuevos scores de riesgo de embolia en la (FANV), riesgo de sangrado, y los resultados de 3 trabajos multicéntricos que comparan dabigatran, rivaroxaban y apixaban vs. warfarina en prevención del (ACV) asociado a (FANV). Intenta, de acuerdo a lo anterior, un posicionamiento de los nuevos anticoagulantes orales (NAO) como opción frente a la warfarina. Realiza consideraciones prácticas generales y en situaciones puntuales para el uso de los (NAO).
Non valvular atrial fibrillation (NVAF) is the most common sustained arrhythmia. NVAF-associated stroke is a devastating, preventable condition with neurological sequels, recurrences, early mortality and greater than NVAF-independent stroke annually. Warfarin showed a 64% risk reduction in primary prevention. The paper herein approaches new risk scores for embolism in NVAF, risk for bleeding, and the results of 3 multicentric studies comparing dabigatran, rivaroxaban and apixaban vs. Warfarin in the prevention of NVAF-associated stroke. Based on the above, it is intended to position the new oral anticoagulants (NOA) as a potential option vis à vis warfarin. The authors reach practical considerations, both general and in specific situations for the use of NOAs.