Abstract

A PROSPECTIVE STUDY ON MONITORING AND EVALUATION OF WARFARIN/ACENOCOUMAROL IN A TERITIARY CARE HOSPITAL

Dr. Mohammed Abuzar Ghufran*, Dr. Wajeeha Qhudsia Siddiqua, Dr.Nomulu Susmitha

ABSTRACT

The study aimed is to monitor and evaluate warfarin/Acenocoumarol and determinants of increase in INR among inpatients associated with the therapy. A prospective study carried out on 143 patients at Care hospitals Nampally from October 2016-May 2017, patients were followed from date of admission until discharge. Each medication was checked for DDI‟s with comparison of Increase/Decrease INR by using Micromedex® online drug reference. Data were analyzed using statistical software, SPSS for windows version 10. The bleeding complications and independent variables was assessed using binary logistic regression analysis. Of the total 143 patients enrolled in the study, Male: females were 75(54.7%): 68 (47.5%). The mean age was 54.08 ± 14.4. According to the Micromedex® online drug reference, a total of 448 DDIs were identified. There were 3.2 ± 2.0 mean number of significant DDIs per patient. The most common type of interaction was Major type 230 (51.3%) while Moderate were 218 (48.6%). Each patient has three major DDI interactions. The frequent interacting drugs were Antibiotics 172 (38.3%). Of all 131(91.6%) of patients treated with Acenocoumarol shown 11(8.3%) of ADR‟s and 12 (8.3%) patients treated with warfarin shown 2(16.6%) of ADR‟s. Acenocoumarol is safe in all age groups. A total 13 ADRs were identified associated with antibiotics. Increase in INR value was found to be strongly associated with risk of bleeding (p=0.0341). Acenocoumarol is effective and safe in broad number of patient‟s which has shown lesser incidence of ADR‟s when compared to warfarin. Bleeding complications occur due to improper management of warfarin/Acenocoumarol.

Keywords: DDI?s-drug-drug interactions, ADR-adverse drug interaction, INR-international normalized ratio, SPSS-statistical package for social sciences.