小児患者に対する薬剤師による投与エノキサパリンの影響
Yi Fei Heng1, Andrew Allison1, Emily Clemons1
1Department of Pharmacy (YFH, AA, EC), WVU Medicine Children's Hospital, Morgantown, WV.
まとめ
薬剤師による投与 (PTD) プロトコルでは,小児のエノキサパリン患者における標的の抗Xa濃度が有意に変化しなかった. しかし,PTDは治療的抗凝固効果の達成の正確性と速度を向上させ,薬剤師の治療の質が同じであることを示しました.
科学分野:
- 小児薬理学
- 薬理学
- 抗凝固療法
背景:
- エノキサパリンの薬理学は小児患者では異なっており,抗凝固剤の有効性を確認するには,抗Xa濃度のモニタリングが必要である.
- 薬剤師による投与 (PTD) プロトコルは,静脈性血栓塞栓症の予防と治療におけるエノキサパリン治療の最適化に不可欠です.
研究 の 目的:
- 薬剤師主導のエノキサパリン投与プロトコル (PTD) が小児患者の目標抗Xa濃度達成に与える影響を評価する.
- PTDプロトコル導入前と後の治療用抗Xa濃度の割合を比較する.
主な方法:
- 小児病院での入院患者によるエノサパリン使用の遡及レビュー (2016年1月〜2023年9月).
- エノキサパリンの指示,用量,投与時間,抗Xa濃度,目標達成の評価
- 抽出された抗Xa濃度数,用量調整,精度,目標までの時間を含む二次結果の分析.
主要な成果:
- PTDプロトコル導入前と後の目標抗Xa濃度の達成率において,有意な違いは認められなかった.
- 適切な抗Xa濃度の高頻度と目標までの短い時間は,統計的に有意ではないが,PTD後に観察された.
結論:
- PTD プロトコルの実施は,目標の抗Xa濃度の達成の主要な結果を変えない.
- 投与量調整ガイドラインの一貫した使用は,同様の治療結果に寄与しました.
- 薬剤師の関与は,目標達成率を変えることなく,治療的抗凝固剤のモニタリングと達成の効率に肯定的な影響を及ぼします.
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