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Abstract

THE ROLE OF CLINICAL PHARMACIST IN THE DETECTION AND MANAGEMENT OF DRUG INTERACTIONS WITH WARFARIN

Mohammad Arief*, Harika Bheemavarapu, Sarabu Ajay Kumar

ABSTRACT

Warfarin is a drug which has a narrow therapeutic index and shows a severe bleeding when it is prescribed with other medications like NSAIDS, Phenytoin, which may lead to increase the INR levels in patients unless it is monitored. The present study is an observational, prospective, non-interventional which was carried out at KIMS hospital on 148 patients who were on warfarin therapy from November-2010 to August-2011. Among 148 patients 42 patients had shown an increase in INR levels during their warfarin therapy. Out of 42, 11 patients who were on other medications had shown a profound elevation in INR level, which clearly indicates that the INR level is to be monitored especially when warfarin is prescribed with other medications which may lead to cause a severe bleeding due to increased INR levels. Our study mainly concludes that as there is a risk in adding NSAIDS and other medications which increase the INR levels, an appropriate measure is to be taken to find the alternative drugs to avoid the chance of drug interactions with warfarin and whenever it is possible a proper monitoring is to be done to prevent the risk of bleeding due to elevated INR levels. It is the prime role of a pharmacist to educate the patients to undergo for a regular INR check and provide appropriate advice to physicians and other health care team for alternative drugs which lacks drug interactions with warfarin.

Keywords: Non-Steroidal Anti-inflammatory Agents, Anti-Epileptics, Cyclo-oxygenase 2 inhibitors, International Normalized Ratio.


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