Analysis of patients admitted to the emergency service for warfarin complication and determination of their levels of knowledge and requirements of knowledge about warfarin use

Yıl 2017, Cilt: 34 Sayı: 4, 247 - 250, 10.10.2019

Ali Duman , Ayhan Akoz Bekir Dagli Mucahit Kapci Mucahit Avcil Ferdi Ozdemir

Öz

Warfarin is a cumarol derivative anticoagulant. It shows its effect by antagoniz-
ing the effects of Vitamin K. Warfarin is metabolized in the liver. International
normalized ratio has been developed in the monitorization of warfarin. It is a
drug which has a limited therapeutic index. The difference in sensitivity for
therapy dose among individuals depends on the genetic polymorphism of the
two enzymes in the liver. The objective of our study was to assess the informa-
tion about the demographic characteristics, complications, treatments and the
related factors of the patients who were admitted to our emergency service for
high INR in routine controls and of the cases who had bleeding due to warfarin
overdose. Of the 18-year-old and older patients who were admitted to our emer-
gency service with a complaint related to warfarin use and who had been using
warfarin on admission and patients who had an INR value of over 3.0 although
the patient had no complaints, those who accepted to participate in the study
were included in the study. The results of the demographic characteristics, com-
plications and treatments of the 59 patients included in the study were in paral-
lel with the literature. The rate of patients’ being informed was found as 61%.
Although difference was found when the demographic data of the informed and
non-informed groups and their answers to the questions asked for warfarin in-
formation level were compared, no statistically significant difference was found
(p>0.005). This brings to mind that the information given to patients at the time
of first prescription is not sufficient and it does not turn into a regular training. 

Anahtar Kelimeler

Drug information, Emergency Service, Warfarin, Warfarin complication

Kaynakça

• Acar, A., Hasbahçeci, M., Başak, F., Canbak, T., Çalışkan, M., Alimoğlu, O., 2012. Bleedings caused by warfarin overdose. Dicle Med. J. 39, 223-226.
• Alay, M., Demir, C., Atmaca, M., Esen, R., Dilek, İ., 2011. Oral antikoagulan tedavi seyrinde kanama komplikasyonu ile gelen hastaların değerlendirilmesi. Van Tıp Derg. 18, 9-14.
• Altunbaş, G., Ercan, S., Davutoğlu, V., Al, B., 2013. Overview of warfarin treatment and answers to questions. JAEM. 12, 38-42.
• Beyan, E., Beyan, C., Vaizoğlu, S.A., 2010. Predisposing prevent-able factors in patients with bleeding due to warfarin us-age: Evaluation of 114 patients. Clin. Appl. Thromb. Hemost. 16, 684-687.
• Dentali, F., Ageno, W., Crowther, M., 2006. Treatment of coumarinaqssociated coagulopathy: A systematic review and proposed treatment algorithms. J. Thromb. Haemost. 4, 1853-1863.
• Eroğlu, M., Çınar, O., Çevik, E., Yamanel, L., Durusu, M., İnal, V., Cömer, B., 2011. The analysis of cases admitted to ıntensive care units from emergency department due to complications related to warfarin treatment. Turk. J. Emerg. Med. 11, 9-12.
• Eroğlu, S.E., Denizbaşı, A.A., Özpolat, Ç., Akoğlu, H., Onur, Ö.E., Ünal, E.A., 2012. The ınvestigation of the relation between ınr levels and risk of complication in patients with a history of warfarin use. Marmara Med. J. 25, 138-142.
• Güven, F.M.K., Yavuz, C., Turkdogan, K.A., Karahan, O., Demirtas, S., Caliskan, A., Celik, M., 2012. Investigation of VKORC1 gene polymorphism in patients with bleeding complaints due to warfarin. Int. J. Basic and Clin. Studies. 1, 27-40.
• Mercan, S., Enç, N., 2011. Educational needs of patients with warfarin. Turk. J. Cardio. Nursing. 1, 12-17.
• Turkdogan, K.A., Karabacak, M., Akpinar, O., Karahan, O., Güven, F.M.K., Engin, A., Turkdogan, F.T., 2013. The VKORC1 gene homozygous polymorphism is markedly higher in Crimean Congo Hemorrhagic Fever patients. Biomed. Res. 24, 415-420.
• Yaka, E., Pekdemir, M., Yılmaz, S., Akalın, E., 2011. Acil servis hastalarında oral antikoagülan tedavi bilgi düzeylerinin araştırılması. Tr. J. Emerg. Med. 11,155-160.