• 한국임상약학회지
• /
• 제26권3호
• /
• pp.195-200
• /
• 2016

Background: Venous thromboembolism (VTE) is a common and life-threating condition in cancer patients. Low molecular weight heparins (LMWH), such as dalteparin, are recommended in the treatment of VTE. Also, rivaroxaban, an orally administered direct factor Xa inhibitor, was approved for the treatment of VTE. It showed similar efficacy to standard therapy (LMWH or warfarin) and was associated with significantly lower rates of major bleedings. However, in the real world, bleeding has been reported to occur frequently in cancer patient receiving rivaroxaban. The goal of this research was to analyze bleeding risks between rivaroxaban and dalteparin for treatment of VTE in cancer patients. Methods: Medical records of oncology patients who were treated with rivaroxaban or dalteparin for VTE from July 2012 to June 2014 were retrospectively reviewed. Data collected were as follows: age, sex, weight, height, cancer types and stages, ECOG (eastern cooperative oncology group) PS (performance score), VTE types, concurrently used medications, study drug information (dose and duration of therapy), INR (international normalized ratio), PT (prothrombin time), and platelet counts. Bleeding was classified into major bleedings, clinically relevant non-major bleedings, and minor bleedings. Results: A total of 399 patients were included in the study. Of these patients, 246 were treated with rivaroxaban and 153 with dalteparin. Bleeding rates were significantly higher in the rivaroxaban group than in the dalteparin group (adjusted odds ratio (AOR) 2.09, 95% CI 1.22-3.60) after adjusting for confounders. In addition, rivaroxaban remained independently associated with 1.78-fold (95% CI 1.14-2.76) shorter time to bleeding compared to dalteparin after adjusting other factors known to be associated with poor outcomes. Conclusion: This study suggested that rivaroxaban was associated with an increased risk of bleedings in cancer patients.

• 한국임상수의학회지
• /
• 제39권5호
• /
• pp.253-257
• /
• 2022

A 5-year-old castrated male Golden Retriever dog weighing 15 kg presented with evidence of intestinal intussusception. The patient had cachexia and severe dehydration before being referred to our department. Ultrasound imaging revealed a target sign indicative of intestinal intussusception. Emergency surgery was performed shortly after diagnosis. After a successful surgery, the patient was hospitalised for postoperative care. Initial treatment was aimed at the reversion of dehydration and the provision of adequate nutrition. Fluid therapy and central parenteral nutrition were administered via the peripheral and central venous catheters, respectively. Ten days postoperatively, swelling and edema were observed in the head and neck. Ultrasound and computed tomography confirmed complete blockage of the cranial vena cava due to thrombosis, which consequently obstructed both the left and right jugular veins. For treatment, dalteparin and tissue plasminogen activator were administered. However, the patient lost all of its vital function on the daybreak of postoperative day 11. Venous thrombus formation secondary to central parenteral nutrition application via the central line is a rare but possible complication. Veterinarians who are concerned about taking care of patients receiving CPN through the central line should keep the possibility of venous thrombus formation in mind.

• Journal of Digestive Cancer Research
• /
• 제1권2호
• /
• pp.108-110
• /
• 2013

전체 정맥혈색전증 환자의 20% 이상이 암과 관련이 있고, 암 환자에 있어 혈색전증은 두 번째 사망 원인으로 작용하고 있어 이에 대한 효과적인 예방과 치료가 사망률을 감소시킬 수 있는 것으로 알려져 있다. 혈색전증 진단에 있어 혈액검사로 D-dimer 측정 및 영상검사로 도플러 초음파, 전산화단층혈관 촬영술을 사용한다. 치료 약제로 경구 비타민 K 길항제가 사용되었으나, 최근에는 정기적인 모니터링이 필요하지 않은 약제들이 새롭게 사용되고 있다. 저자들은 진행성 위암환자에서 발생한 하지 심부정맥 혈전증 및 폐동맥 혈색전증에 있어 저분자량 헤파린을 투여하며, 호전된 사례를 문헌고찰과 함께 보고하는 바이다.

• 한국보건간호학회지
• /
• 제16권1호
• /
• pp.176-189
• /
• 2002

The purpose of this study were to illustrate the various medication error types and causes and identified to related drugs to provide basic data for preventing nurses' medication error by analysing 73 cases of AJN 'medication Error' column(1993, Oct -2000, Nov). Nurses' types of medication error were classified into 7 types. The most frequent error types are wrong medication$(21.9\%)$ and the wrong dose$(21.9\%)$ together. The others are wrong $time(4.1\%)$, $omission(2.7\%)$, mechanical $error(2.7\%)$, incorrect IV $rate(1.4\%)$. wrong route $administration(1.4\%)$ in order. Nurses' causes of medication error were 9 kinds. The most frequent type is confusing between similar drug shape, color, size, name, injection devices and patient's $name(43.9\%)$ and the others are lack of knowledge about $drugs(26.8\%),\; slips(7.3\%),\; miscalculating\;dose(4.9\%)$, incorrect adjusts $devices(4.9\%)$, difficulty to read or illegible decimal $point(4.9\%),$ $abbreviation(2.4\%)$, fatigue with $overwork(2.4\%)$ and no communication with $patient(2.4\%)$ in order. Related drugs with medication error are as follows. - dose unit(IU. minims. mcg/min. mEq) : Heparin. insulin. synthetic calcitonin, some enzymes and hormones, vitamins, some antibiotics, tuberculin injection. MgSO4 injection. nitroglycerin - similar size, color and shape drug : $0.9\%$ N/S and acetic acid $0.25\%$ for irrigation. premixed 2mg lidocaine sol. and $0.9\%$ N/S, gentamycin 20mg/2mL for children and 80mg/2mL for adult, dextroamphetamine 5mg and 10mg capsule. sedatives chloral hydrate 250mg/5mL and 500mg/5mL - similar name :Aredia(pamidronate disodium) and Adriamycin(doxorubicin), Lamictal (lamotrigine) and Lamisil 250mg. Elderpryl and enalapril, cefotaxime and cefoxitin, carboplatin and cisplatin, sumatriptan and zolmitriptan, Celebrex and Celexa, Humulin and Humalog, Percodan and Percocet, Diabeta and Diabinese, Epivir and Retrovir, Xanax(alprazolam) and Zantac(ranitidine) - decimal point : low molecular weight warfarin, methotrexate - unfamiliar drug uses of familiar drug ; methotrexate. droperidol, imipramine, propranolol - number of drug name(misleading chemical name) : 6-thioguanine, 6-mercaptopurine, 5-fluorouracil - type of administration route : Oxycodone(OxyContin). - administration time : acarbose(Precose). - injection way (Z-track method): hydroxyzine - epidural cathether : LMWHs(enoxaparin, dalteparin), - ADD Vantage self contained delivery system : ceftriaxone(Rocephin)