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Study of Drug-drug Interactions among Patients on Warfarin Therapy at Medani Heart Centre Gezira State, Sudan

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dc.contributor.author Omer, Ahmed Altayeb Ali
dc.date.accessioned 2018-08-02T08:08:42Z
dc.date.available 2018-08-02T08:08:42Z
dc.date.issued 2016-02-18
dc.identifier.uri http://repo.uofg.edu.sd/handle/123456789/1121
dc.description A Dissertation Submitted to the University of Gezira in Partial Fulfillment of the Requirements for the Award of the Master Degree in Phamacy (M.Pharm) in Clinical Pharmacology , Department of Pharmacology,Faculty of Pharmacy, February/ 2016 en_US
dc.description.abstract Warfarin is efficacious anticoagulant, but achieving its the desired anticoagulant effects is difficult because of its narrow therapeutic index. This study aimed to evaluate warfarin-drug interactions among patients (n=104) on warfarin therapy at Medani Heart Centre. This study revealed that warfarin was mainly indicated for mechanical valve replacement (n=61; 58.7%), atrial fibrillation (n=34; 32.7%) and myocardial infarction (n=5; 4.8%). A large number of patients (n=90; 86.5%) showed International Normalized Ratio (INR) below (n=46; 51.1%) and above (n=44; 48.9%) the normal range (2-3). There were 4 patients had more than drug-drug interactions, 20 (19.2%), 34 (32.7%) and 33 (31.7%) had 11-15, 6-10 and 1-5 drug-drug interactions respectively. The majority of patients (n=38; 36.5%) had one drug interaction with warfarin, 31 (29.8%) and 15 (14.4%) patients had two and three warfarin-drug interactions respectively. According to Medscape Reference Drug Interaction Checker there was 97 (93.26%) patients had at least one drug-drug interaction in their medication profile. It was also there were 92 (88.46%) patients had at least one warfarin-drug interaction in their medication profile. The most frequent drug-drug interaction with analgesics (n=54; 30.3%), followed by cardiovascular drugs (n=51; 28.6%) and anticoagulants (n=46; 25.8%). The most common type of interaction with warfarin according to Medscape Reference was significant type which was found in 53 (51%) patients, whereas serious warfarin-drug interaction occurred in 39 (37.5%) patients. According to this study, warfarin-drug interactions were evident to be high, resulting in fluctuation of International Normalized Ratio. Thus physicians should be aware about the serious warfarin-drug interaction, moreover there is an urgent need for a clinical pharmacist to improve the patient clinical outcomes. en_US
dc.description.sponsorship Imad Eldin Mohammed Taj Eldin ( Main supervisor ) Abd Almahmood Nour Eldaem Hag Elsiddig ( Co- supervisor ) en_US
dc.language.iso en en_US
dc.publisher University of Gezira en_US
dc.subject pharmacology en_US
dc.subject Heart disease en_US
dc.subject Coagulation Cascade en_US
dc.subject Pharmacokinetic properties en_US
dc.subject Warfarin Chemical en_US
dc.title Study of Drug-drug Interactions among Patients on Warfarin Therapy at Medani Heart Centre Gezira State, Sudan en_US
dc.type Thesis en_US

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