지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
초록· 키워드
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Drugs with a narrow therapeutic index (NTI) require very precise dosing. Warfarin and digoxin are the examples of NTI-drugs and dosing of them varies widely for different patients. However, in South Korea, only two strengths of warfarin and one of digoxin are commercially available. This is a big barrier for the precise dispensing and has potential safety risks to patients, particularly to elderly patients. To find a potential solution to the problem, an analysis of the prescribed doses and dispensing patterns of those drugs was performed. Data were collected by computer-facilitated prescription review in a university hospital. The period screened was from May 1st, 2012 to April 30th, 2013. All the prescriptions with either warfarin or digoxin tablets were selected for this study and dispensing patterns were analyzed according to the prescribed doses. A total of 17,017 warfarin prescriptions were analyzed; 8,148 for inpatient prescriptions, 8,869 for outpatient prescriptions, respectively. Of the 23 kinds of prescribed doses, 2 mg (19.9%) was most frequent, followed by 3 mg (13.2%) and 2.5 mg (11.7%). By analyzing the dispensing patterns, 60.3% (10,253) of the prescriptions required pill splitting and 72.0% of them were for the patients 65 years old and over. On the other hand, 4,350 digoxin prescriptions were included in this study. Of the 6 kinds of prescribed doses, 0.125 mg (71.2%) was most frequent, followed by 0.0625 mg (20.2%). Among the prescriptions for digoxin, 92.0% (3,998) should be split and 65.7% of them were for the patients aged 65 years and over. Despite limitations of strengths, various doses of warfarin and digoxin were prescribed. Furthermore, more than half of the prescriptions that required pill splitting were for elderly patients. The results from this study suggest that different strengths of warfarin and digoxin should be provided for accuracy of dispensing and safety for patients receiving them.
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참고문헌 (23)
참고문헌 신청
Choonara, I. A. / 1988 / The relationship between inhibition of vitamin K1 2,3-epoxide reductase and reduction of clotting factor activity with warfarin / Br. J. Clin. Pharmacol 25:1
Nelsestuen, G. L. / 1976 / Role of gamma-carboxyglutamic acid: an unusual transition required for calcium-dependent binding of prothrombin to phospholipid / J. Biol. Chem 251:5648
Malhotra, O. P. / 1985 / The kinetics of activation of normal and gamma carboxy glutamic acid deficient prothrombins / J. Biol. Chem 260:279
Kirley, K. / 2012 / National Trends in Oral Anticoagulant Use in the United States, 2007 to 2011 / Circ Cardiovasc Qual Outcomes 5:615
National Health Insurance Service
Nelsestuen, G. L. / 1976 / Role of gamma-carboxyglutamic acid: an unusual transition required for calcium-dependent binding of prothrombin to phospholipid / J. Biol. Chem 251:5648
Malhotra, O. P. / 1985 / The kinetics of activation of normal and gamma carboxy glutamic acid deficient prothrombins / J. Biol. Chem 260:279
Kirley, K. / 2012 / National Trends in Oral Anticoagulant Use in the United States, 2007 to 2011 / Circ Cardiovasc Qual Outcomes 5:615
National Health Insurance Service
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