Adverse drug reactions anticoagulants

However, there are two discordant reports. A patient stabilised on dicou-maroi developed multiple ecchymoses and a prothrombin time of 53 seconds within 2 weeks of starting to take diazepam 5 mg four times daily. The New Zealand Committee on Adverse Drug Reactions has received one report of an increased anticoagulant effect in a patient taking warfarin with diazepam. It is by no means certain that these responses were due to an interaction. 

The LMWHs cause fewer adverse reactions tiian heparin. Bleeding related to die LMWHs is possible but has generally been low. See die Summary Drug Table Anticoagulants for additional adverse reactions associated widi die LMWHs. 

Some examples of this approach are the linkage of adverse outcomes of inappropriate anticoagulation (stroke, myocardial infarct, or death widiin 6 days) to the measurement of prothrombin times and the linkage of adverse effects of digoxin therapy (death or hospitalization caused by insufficiency, overdose, or drug reaction) with the measurement of digoxmd ... 

Discuss ways to promote an optimal response to therapy, how to manage common adverse reactions, and important points to keep in mind when educating patients about the use of an anticoagulant or thrombolytic drug. 

Soybean oil is widely used intramuscularly as a drug vehicle or as a component of emulsions used in parenteral nutrition regimens it is also consumed as an edible oil. Generally, soybean oil is regarded as an essentially nontoxic and nonirritant material. However, serious adverse reactions to soybean oil emulsions administered parenterally have been reported. These include cases of hypersensitivity, CNS reactions, " and fat embolism. " Interference with the anticoagulant effect of warfarin has also been reported. ... 

Toxicity Adverse effects include gastrointestinal irritation, headache, and dark coloration of urine. More serious toxicity includes leukopenia, dizziness, and ataxia. Drag interactions with metronidazole include a disulfiram-like reaction with ethanol and potentiation of coumarin anticoagulant effects. Although it is not contraindicated in pregnancy, the drug should be used with caution. 

Besides alcohol, some cephalosporins (cefamandole, cefimetazole, cefopera-zone, or cefotetan) expose the patient to an increased risk of hemorrhaging if administered with anticoagulants such as coumarin or indanedione, heparin, and with clot-busting drugs such as thrombol5 cs. The same adverse reaction might occur if the patient takes NSAlDs, especially aspirin, or sulfinpyrazone (Anturane) while on cephalosporins. 

It is important to note that an accurate economic model of this problem is impossible to construct. Adverse events are not caused by unusual or rare circumstances (Johnson and Bootman, 1997). Rather, these events make up a familiar list, including wound infections, drug overdoses, administration of the wrong drugs, bleeding from anticoagulation, insulin reactions, missed diagnoses, and falls. Because these risks and events are known and predictable, they are also preventable. It is estimated that these preventable events represent 69.6 percent of medical accidents (Leape and others, 1993). 

Warfarin is the most commonly prescribed oral anticoagulant, with four million U.S. patients taking the drug for treatment and prevention of atrial fibrillation, stroke, deep vein thrombosis, or pulmonary embolism, and for those who have had heart valve replacement surgery. Adverse reactions to warfarin... 

---