INCIDENCE AND FACTORS ASSOCIATED WITH BLEEDING IN PATIENTS RECEIVING CONCOMITANT FIBRINOLYTIC AGENTS AND CORTICOSTEROIDS THERAPY

Authors

  • Narisa Ruenroengbun Department of Pharmaceutical Care, Faculty of Pharmacy, Silpakorn University, Sanamchandra Palace Campus, Nakhon Pathom
  • Ketsiree Kongsuwan Department of Pharmaceutical Care, Faculty of Pharmacy, Silpakorn University, Sanamchandra Palace Campus, Nakhon Pathom
  • Maleewan Dokkaewklang Department of Pharmaceutical Care, Faculty of Pharmacy, Silpakorn University, Sanamchandra Palace Campus, Nakhon Pathom
  • Apichaya Lakkasorn Department of Pharmaceutical Care, Faculty of Pharmacy, Silpakorn University, Sanamchandra Palace Campus, Nakhon Pathom
  • Arphapron Ardsean Department of Pharmaceutical Care, Faculty of Pharmacy, Silpakorn University, Sanamchandra Palace Campus, Nakhon Pathom
  • Piyawan Srimanee Pharmacy Department, Nakhon Pathom Hospital, Nakhon Pathom
  • Nattapong Kanchanakomala Medicine Department, Nakhon Pathom Hospital, Nakhon Pathom
  • Kawin Duangmee Department of Pharmaceutical Care, Faculty of Pharmacy, Silpakorn University, Sanamchandra Palace Campus, Nakhon Pathom

Keywords:

Thrombolytic agents, Steroids, Streptokinase, Alteplase

Abstract

Fibrinolytic agents are used to treat thromboembolism for several indications due to their efficacy. However, they can increase the risk of bleeding and type I hypersensitivity reactions. In clinical practice, the premedication strategy with corticosteroids was used to prevent these hypersensitivity reactions but may also increase the risk of bleeding. This retrospective cohort study analyzed the incidence and factors associated with bleeding in patients receiving concomitant fibrinolytic agents and corticosteroid therapy. Data were collected by electronic databases and medical records at Nakhon Pathom Hospital from January 2019 to July 2022 using a data collecting form. A total of 106 patients who received streptokinase or alteplase in combination with corticosteroids were bleeding in 14.3% and 44.8%, respectively. Factors associated with bleeding that are statistically significant include the history of cerebrovascular accident (OR 10.11, 95%CI 1.4 - 74.0, p-value 0.023), hypertension (OR 8.45, 95%CI 1.8 - 40.1, p-value 0.007) and receiving two corticosteroids (OR 6.07, 95%CI 1.3 - 28.3, p-value 0.022). Therefore, it is necessary for healthcare professionals to closely monitor the occurrence of bleeding in patients receiving fibrinolytic drugs and corticosteroids, especially among patients with these risk factors.

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Published

2023-08-31

Issue

Vol. 19 No. 1 (2024): JANUARY-JUNE 2024

Section

Original Research Articles

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