International Journal of Health and Clinical Research
Yazarlar: Ratul Banerjee, Ananya Manadal, Sonai Mandal, Syed Mohammad Naser
Konular:-
Anahtar Kelimeler:Antiplatelet,Fibrinolytic,Anticoagulant,CU
Özet: Introduction: There is widespread use of antiplatelet agents, fibrinolytics and anticoagulants among patients admitted with cardiac emergencies in the Cardiac care unit (CCU) of this tertiary care teaching hospital. However there are no studies that give an in depth understanding of the extent and rationality of such use.Objective: The objective of this study was to outline the extent and rationality of use of these agents among the patients admitted to the CCU. Design: Record based Cross sectional study.Methods: We assessed the prescriptions and management given to patients admitted to our hospital with cardiac emergencies between three months from the month of February to month of April in the year 2018. The magnitude of use of antiplatelet agents, anticoagulants and fibrinolytics was assessed and rationality of such use was evaluated on a case-to-case basis. Results: Total 47 patients admitted in the CCU with cardiac emergencies, an age range of 18 to 72 years , 48.9% were male. Acute coronary syndrome (including unstable angina, NSTEMI, and STEMI) made up for 59.57% of the diagnosis. Of the 47 patients 4 died and rest were discharged. All patients with ACS were given loading dose of 300mg or 325 mg Aspirin and by chewing and 300mg of Clopidogrel and maintenance dose of either 75mg or 150mg Aspirin orally.All ACS patients got 75 mg clopidogrel as maintainance dose. Another 8.51% patient got Warfarin with Clopidogrel combination for stroke prevention in Atrial fibrillation. Nearly half (48.93%) patients received LMWH and 8.51% got only Warfarin 2 mg orally. Around a quarter of the patients (21.27%) received Streptokinase 1.5 IU by infusion as fibrinolytic therapy. On basis of Harrison’s Text Book 19th edition and ACC/AHA Practical guidelines shows that use of Warfarin due to Atrial fibrillation in 8.51% patient was rational because warfarin is superior than antiplatelet for stroke prevention. Use of Aspirin and Clopidogrel as antiplatelet was rational. All fibrinolytics were also used rationally.Conclusion: To conclude, in most of the patients studied antiplatelets, fibrinolytics and anticoagulant were used rationally and in all the patients.