Pharmacists have an important role to play in helping minimise the high number of adverse reactions from widely-used antithrombotic drugs, according to pharmacy academic Dr Luke Bereznicki.
Dr Bereznicki, lecturer at the University of Tasmania and last year's Young Pharmacist of the Year, will discuss the appropriate use of antithrombotic drugs and ways that reactions can be minimised at this year's Pharmacy Australia Congress being held in Sydney in October.
He told Pharmacy eNews that antiplatelet agents such as aspirin and clopidogrel and anticoagulants such as warfarin were leading to bleeding in patients, particularly when used in tandem.
"What we are tending to see are these agents being used in combination, particularly for the management of acute coronary syndrome, but also with people with coexisting conditions like ischaemic heart disease and atrial fibrillation," Dr Bereznicki said.
"They are a very commonly-used group of drugs with a very high risk of adverse events."
Dr Bereznicki said one of the key ways that pharmacists could help minimise the adverse effects was through the promotion of patient self monitoring – something that, he claimed, would help at least a quarter of people on warfarin.
"It's not something that is suitable for all patients but selected people on warfarin can be identified and trained by pharmacists to use a portable monitor at home and it just gives them a greater control of their therapy and tends to improve the amount of time they spend in their target range and reduces their bleeding risk," he said.
According to Dr Bereznicki, the other important role for pharmacists in managing antithrombotic use is through medicine reviews.
"If you performing medicine reviews, you are often recommending that the patient be commenced on something," he said.
"Perhaps they have atrial fibrillation and it's not treated or perhaps they are taking warfarin and warfarin is not suitable because they are not adherent or they have developed another contraindication that someone else might not know about.
"So we need to make sure that a patient with atrial fibrillation is being appropriately treated, whether that treatment is with aspirin, clopidogrel or warfarin.
"And then of course we have to think about what other condition they have. Do they have conditions that predispose to bleeding? Have they had a history of gastrointestinal problems?
"As a pharmacist we need to think about any other medications they are taking. Based on all that information, we would make an appropriate choice of agent."
The Pharmacy Australia Congress will be held at the Hilton in Sydney from 15-18 October.