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Farmaceutska zdravstvena zaštita u terapiji duboke venske tromboze

dc.creatorVezmar-Kovačević, Sandra
dc.creatorĆulafić, Milica
dc.creatorMiljković, Branislava
dc.date.accessioned2019-09-02T11:36:54Z
dc.date.available2019-09-02T11:36:54Z
dc.date.issued2013
dc.identifier.issn0004-1963
dc.identifier.urihttps://farfar.pharmacy.bg.ac.rs/handle/123456789/2014
dc.description.abstractAnticoagulation therapy is commonly used in deep vein thrombosis (DVT) prophylaxis associated with surgical interventions and in treatment of patients with DVT, atrial fibrillation and prosthetic heart valves. Long-term treatment is usually initiated with parenteral heparin (unfractionated or low molecular weight) or fondaparinux followed by concomitant warfarin use (5-10 mg). Oral anticoagulants such as warfarin and coumarin derivatives are efficient in treatment and prevention of thromboembolic events but are also associated with increased risk of potentially fatal hemorrhages. Drug doses are adjusted to achieve international normalized ratio (INR) of 2.5 (2-3) in patients with DVT, atrial fibrillation and prosthetic heart valves, or 3.5 (3-4) in patients with recurrent DVT or pulmonary embolism. INR is influenced by warfarin/acenocoumarol interactions with other conventional and herbal medicines dietary supplements, consumption of vitamin K rich food, presence of comorbidities such as heart failure, hepatic insufficiency, hypo- and hyperthyrodism, older age, alcohol consumption and adherence. Moreover, caution is needed in surgical events and dental interventions. Due to the small INR window and the risk of hemorrhage, patient counseling is of great importance. The role of the pharmacist is to counsel about regular and appropriate drug use, food consumption and possibilities of decreasing the hemorrhage risk. Counseling can be performed as part of the standard service offered to patients in primary or secondary care or, as in case of developed health-care systems, in anticoagulation clinics, where pharmacists play an important role due to their competences.en
dc.description.abstractAntikoagulantna terapija se najčešće primenjuje u profilaksi duboke venske tromboze (DVT) kod hirurških zahvata i u terapiji pacijenata sa DVT, atrijalnom fibrilacijom i veštačkim srčanim zaliscima. U bolničkim uslovima, dugotrajna terapija počinje parenteralnom primenom heparina (nefrakcionisanog ili niskomolekularnog) ili fondaparinuksa uz istovremenu oralnu primenu varfarina (5-10 mg). Oralni antikoagulansi poput varfarina i kumarinskih derivata efikasni su u lečenju i prevenciji tromboembolijskih događaja ali sa sobom nose povišen rizik od pojave potencijalno fatalnih krvarenja. Doziranje lekova se prilagođava sa ciljem postizanja vrednosti internacionalnog normalizovanog odnosa (INR) 2,5 (2-3) kod DVT, veštačkih srčanih zalistaka i atrijalne fibrilacije odnosno 3,5 (3-4) kod pacijenata sa rekurentnom DVT ili plućnom embolijom. Na vrednost INR mogu uticati: interakcije lekova, biljnih i dijetetskih suplemenata sa varfarinom/acenokumarolom, konzumiranje hrane bogate vitaminom K, prisustvo komorbiditeta poput srčane i hepatičke insuficijencije, hipo- i hipertiroidizma, starost pacijenta, konzumacija alkohola i stepen adherence. Takođe, oprez je potreban pri hirurškim zahvatima i posetama stomatologu. Zbog uskog terapijskog opsega INR vrednosti i potencijalnog rizika od hemoragije, potrebno je posvetiti posebnu pažnju savetovanju pacijenata na terapiji varfarinom/acenokumarolom. Uloga farmaceuta ogleda se u savetovanju o redovnoj i pravilnoj primeni leka, pravilnom načinu ishrane i mogućnostima minimiziranja rizika od pojave krvarenja. Savetovanje se može vršiti u okviru usluge koja se pacijentima pruža u primarnoj i sekundarnoj zdravstvenoj zaštiti ili, kao što je slučaj u razvijenim zdravstvenim sistemima, u antikoagulantnim ambulantama u čijem radu, zbog svoje kompetentnosti, značajna uloga pripada farmaceutima.sr
dc.publisherSavez farmaceutskih udruženja Srbije, Beograd
dc.rightsopenAccess
dc.rights.urihttps://creativecommons.org/licenses/by-sa/4.0/
dc.sourceArhiv za farmaciju
dc.subjectpatient counselingen
dc.subjectdeep vein thrombosisen
dc.subjectanticoagulantsen
dc.subjectsavetovanje pacijenatasr
dc.subjectduboka venska trombozasr
dc.subjectantikoagulansisr
dc.titlePharmaceutical care in the treatment of deep vein thrombosisen
dc.titleFarmaceutska zdravstvena zaštita u terapiji duboke venske trombozesr
dc.typearticle
dc.rights.licenseBY-SA
dcterms.abstractВезмар-Ковачевић, Сандра; Ћулафић, Милица; Миљковић, Бранислава; Фармацеутска здравствена заштита у терапији дубоке венске тромбозе; Фармацеутска здравствена заштита у терапији дубоке венске тромбозе;
dc.citation.volume63
dc.citation.issue2
dc.citation.spage196
dc.citation.epage215
dc.citation.other63(2): 196-215
dc.citation.rankM53
dc.identifier.fulltexthttps://farfar.pharmacy.bg.ac.rs//bitstream/id/771/2012.pdf
dc.identifier.rcubconv_493
dc.type.versionpublishedVersion


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