ناقشت بنجاح طالبة الماجستير سحر محمد عديلي من قسم الصيدلة السريرية اليوم الخميس الموافق 22/12/2016م أطروحة الماجستير بعنوان:
تقييم النظم العلاجية لعقار اينوكسابارين المستخدم عند المرضى الذين يعانون من السمنة في الأردن
EVALUATION OF ENOXAPARIN DOSING REGIMENS USED IN OBESE PATIENTS IN JORDAN
وقد ضمت لجنة المناقشة الدكتورة ليندا طحاينة رئيساً وعضوية كل من الدكتورة نور صوالحة والدكتورة أمل العكور كممتحن خارجي. باسم صفحة أصدقاء كلية الصيدلة_ في جامعة العلوم والتكنولوجيا الأردنية نبارك للطالبة سحر عديلي إتمامها درجة الماجستير في الصيدلة السريرية بنجاح وتفوق متمنين لها مزيدا من التقدم.
للإطلاع على ملخص الدراسة
Background: Enoxaparin is the most commonly used low molecular weight heparin in clinical settings. Optimum doses of enoxaparin are very essential to ensure the desired antithrombotic effect, and to avoid adverse effects such as bleeding. Obesity is a serious public health problem with very high prevalence. In Jordan obesity rates have significantly increased recently. Enoxaparin recommended doses for both prophylactic and treatment indications are not always effective and safe in obese patients.
Objectives: The study main objective was to investigate enoxaparin dosing regimens used in obese and morbidly obese patients, and to assess the degree of anticoagulation achieved with enoxaparin dosing regimens used in a hospital setting in Jordan. In addition to investigate short term and long term health outcomes associated with enoxaparin dosing regimens used in obese and morbidly obese patients including side effects.
Methodology: Our study performed prospectively at KAUH. All obese adult patients (18 years and older) not currently participating in a clinical study and being prescribed enoxaparin for prophylactic or treatment purposes were invited to participate in the study. Those who agreed to participate had the research goals and methods explained to them and signed an informed consent.
After signing informed consent, patients were interviewed and medical records reviewed to collect demographics and relevant clinical characteristics. Baseline complete blood count and anti-Xa were measured for each patient during hospital stay, clinical assessment of VTE symptoms, major and non-major bleeding and thrombocytopenia were also assessed.
Results: 86 patients were enrolled in the study; however, 52 patients completed the study. The study found that 51.2% (n= 44) of the study population was obese and 48.8% (n= 42) was morbidly obese. Body mass index ranged from (30.02 to 70.38) kg/m2, mean BMI was 37.00 kg/m2 and median BMI was 34.74 kg/m2.The mean anti-Xa level for treatment group was 0.483 IU/ml, and the mean anti-Xa level for prophylactic group was 0.2196 IU/ml. Among the 52 patients, 19 patients (36.5%) had therapeutic anti-Xa level, and 33 patients (63.5%) had non-therapeutic anti-Xa level and most of them were on capping dosing regimens. Four different dosing regimens were used at KAUH for either treatment or prophylaxis indications. The results showed no significant difference between regimens that were used and therapeutic anti-Xa level (P- values >0.05).No bleeding events or thrombocytopenia were noticed, but there was one case of recurrent thrombosis.
Conclusion: The dosing regimens of enoxaparin currently used for obese patients at KAUH vary based on prescribing physicians. Some patients were prescribed the capping dosing regimens and some were prescribed higher or non-capping dosing regimens. The majority of participant had non-theraputic anti-Xa.
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