Analysis of occurrence of bleeding related to combination therapy with warfarin and other drugs in patients in Department of Cardiovascular Medicine
10.3760/cma.j.issn.1008-5734.2014.01.005
- VernacularTitle:心血管内科患者华法林与其他药物联用相关的出血发生情况分析
- Author:
Henghai SU
1
;
Guangyan MU
;
Qian XIANG
;
Ying ZHOU
;
Yimin CUI
Author Information
1. 广西壮族自治区人民医院药学部
- Publication Type:Journal Article
- Keywords:
Warfarin;
Drug interactions;
Hemorrhage
- From:
Adverse Drug Reactions Journal
2014;16(1):15-21
- CountryChina
- Language:Chinese
-
Abstract:
Objective To understand occurrence of bleeding related to drug interactions in patients who received combined treatment with warfarin and other drugs in Department of Cardiovascular Medicine and investigate control measures.Methods The data of inpatients using warfarin in the Department of Cardiovascular Medicine,Peking University First Hospital from January 2012 to June 2013 were collected and analyzed retrospectively.The conditions of concomitant drugs and occurrence of bleeding possibly caused by drug interactions were recorded and the drugs which were commonly used in the Department were screened.Results A total of 141 patients were enrolled including 90 men aged from 21 to 83 years with an average age of (63 ± 13) years and 51 women aged from 43 to 85 years with an average age of (65 ± 11)years.Most protopathy was atrial fibrillation which accounted for 79.4％ (112 cases).Of the 141 patients,there were 14 cases (9.9％) of slight bleeding possibly because of drug interactions including 5 cases of stool occult blood,3 cases of dermal ecchymosis and 1 case had each of the following:operative wound bleeding,oral mucosal bleeding and blood in phlegm,colporrhagia,epistaxis,hematuresis,and gum bleeding.The occurrence of bleeding in the 14 patients involved totally 9 kinds of drugs containing low molecular weight heparin (related to 9 cases),atorvastatin (related to 6 cases),amiodarone (related to 4 cases),acarbose (related to 3 cases),aspirin (related to 4 cases),propafenone (related to 3 cases),omeprazole (related to 2 cases),clopidogrel (related to 2 cases),and moxifloxacin (related to 1 case) and,of them,the highest occurrence was due to low molecular weight heparin,which accounted for 64.2％.In the 9 kinds of drugs in the 141 patients,low molecular weight heparin had the highest concomitant frequency combined with warfarin accounted for 73.1％ (103/141) and moxifloxacin had the highest bleeding incidence accounted of 1/5.Conclusions Bleeding may be caused by drug reactions due to combination therapy with warfarin and parts of clinical common cardiovascular drugs.Positive clinical pharmaceutical care of warfarin will be of great importance in prevention of bleeding.
