Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492010000200003
Jornal Vascular Brasileiro
Original Article

Conhecimento sobre anticoagulantes orais e seu manejo por médicos de pronto atendimento

Emergency-room doctors' knowledge about oral anticoagulants and its management

Larissa Periotto Borlina; Ewerson Luiz Cavalcanti e Silva; Carolina Ghislandi; Jorge Rufino Ribas Timi

http://dx.doi.org/10.1590/S1677-54492010000200003 J Vasc Bras, vol.9, n2, p.24-28, 2010
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Resumo

Contexto: Desde sua descoberta, os anticoagulantes orais (AO) têm sido cada vez mais estudados e aplicados em diferentes doenças. No entanto, eles apresentam reações medicamentosas com fármacos que trazem riscos ao paciente. Objetivo: Identificar o nível de conhecimento dos médicos plantonistas de pronto atendimento sobre os AO e suas interações, medicamentosas ou não, e verificar se o médico frentista está preparado para integrar o conteúdo teórico com a rotina de urgências. Método: Aplicou-se um questionário a 100 médicos atuantes em pronto atendimentos de dois hospitais públicos e três privados em Curitiba. Visou-se saber se o médico frentista questiona ao paciente sobre o uso de AO. Também, avaliou-se o conhecimento do profissional e seu interesse em saber mais sobre: AO (quais deles conhecia); exames para controle; sinergismo com AO; e manejo das complicações. Resultados: Dos 100 entrevistados, 60% declararam perguntar ao paciente sobre o uso de AO, 81% tinham conhecimento insuficiente a respeito do sinergismo de algumas substâncias apresentadas e os AO, 15% desconheciam qual exame é utilizado para acompanhamento dos pacientes anticoagulados, 50,7% não sabiam os nomes comercias dos AO, 4% desconheciam seu antídoto, e 92% manifestaram interesse em melhorar seus conhecimentos sobre os AO. Conclusão: É BAIXo o número de médicos que atende em pronto atendimentos que conhece sobre os AO e que sabe manejar pacientes anticoagulados. É alta a porcentagem de médicos que não perguntam aos pacientes sobre o uso de AO e que desconhecem princípios do sinergismo medicamentoso, sendo que a maioria se interessou em melhorar seus conhecimentos sobre os anticoagulantes.

Palavras-chave

Anticoagulantes, serviços médicos de emergência, interações medicamentosas

Abstract

Background: Since its discovery, oral anticoagulants (OA) have been increasingly studied and used to treat different diseases. However, OA may cause adverse drug interactions that bring risks for patients. Objective: To identify the emergency room doctors' level of knowledge about OA and their drug-related or non-drug-related interactions, and to verify if emergency room doctors are prepared to integrate their theoretical knowledge and the routine of the emergency room. Method: A questionnaire was administered to 100 emergency room doctors working at two public hospitals and three private hospitals in Curitiba, Brazil. The objective of the questionnaire was to find out: if emergency room doctors asked patients about the use of OA, which OA doctors were familiar with, which control exam would be appropriate, what doctors knew about the synergism with OA, how complications were managed, and if doctors were interested in knowing more about OA. Results: Sixty percent of the doctors reported to ask patients about the use of OA, 81% had insufficient knowledge regarding the synergism between some substances and OA, 15% were unaware of which exams are used to follow up anticoagulated patients, 50.7% did not know the commercial names of OA, 4% were unaware of OA antidotes, and 92% revealed interest in improving their knowledge about OA. Conclusion: The number of emergency room doctors who were familiar with OA is low, as well as the number of those who know how to manage anticoagulated patients. The percentage of doctors who did not ask patients about the use of OA and who were unaware of the principles of drug synergism is high, and most of them were interested in improving their knowledge about anticoagulants.

Keywords

Anticoagulants, emergency medical services, drug interactions

References

Silveira PR, Panico MD. Anticoagulantes. Cirurgia vascular. 2002:375-89.

Ryan F, Byrne S, O'Shea S. Managing oral anticoagulation therapy: improving clinical outcomes. A review. J Clin Pharm Ther. 2008;33:581-90.

Landefeld CS, Beyth RJ. Anticoagulant-related bleeding: clinical epidemiology, prediction and prevention. Am J Med. 1993;95:315-28.

Levy RH, Collins C. Risk and predictability of drug interactions in the elderly. Int Rev Neurobiol. 2007;81:235-51.

Bourget S, Baudrant M, Allenet B, Calop J. Oral anticoagulants: a literature review of herb-drug interactions or food-drug interactions. J Pharm Belg. 2007;62:69-75.

Caprini JA, Tapson VF, Hyers TM. Treatment of venous thromboembolism: Adherence to guidelines and impact of physician knowledge, attitudes, and beliefs. J Vasc Surg. 2005;42:726-33.

Couris RR, Tataronis GR, Dallal GE, Blumberg JB, Dwyer JT. Assessment of healthcare professionals' knowledge about warfarin-vitamin K drug-nutrient interactions. J Am Coll Nutr. 2000;19:439-45.

Agência Nacional de Vigilância Sanitária. c200.

Kakar P, Watson T, Lip GY. Rivaroxaban. Drugs Today. 2007;43:129-36.

Eriksson BL, Dahl OE, Rosencher N. Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement: a randomized, double-blind, non-inferiority trial. Lancet. 2007;370:949-56.

Lassen MR, Davidson BL, Gallus A, Pineo G, Ansell J, Deitchman D. The efficacy and safety of apixaban, an oral, direct factor Xa inhibitor, as thromboprophylaxis in patients following total knee replacement. J Thromb Haemost. 2007;5:2368-75.

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