Pharmacological analysis and remote monitoring of a patient with skin ulcers caused by anticoagulation
A woman in her 76 s has valvular heart disease, atrial fibrillation, and myelodysplastic syndrome. Warfarin bridged with low molecular weight heparin (LMWH), was treated for anticoagulation therapy in this patient. Five days later, The patient informed the anticoagulant management personnel from the...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
KeAi Communications Co., Ltd.
2023-12-01
|
| Series: | Clinical eHealth |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2588914123000278 |
| _version_ | 1797598019803152384 |
|---|---|
| author | Wu Ling Zhou Ru Ji Peiying Haibing Yang Geng Wenye Su Qiongli |
| author_facet | Wu Ling Zhou Ru Ji Peiying Haibing Yang Geng Wenye Su Qiongli |
| author_sort | Wu Ling |
| collection | DOAJ |
| description | A woman in her 76 s has valvular heart disease, atrial fibrillation, and myelodysplastic syndrome. Warfarin bridged with low molecular weight heparin (LMWH), was treated for anticoagulation therapy in this patient. Five days later, The patient informed the anticoagulant management personnel from the APP of abnormal coagulation, thrombocytopenia, and ulcers, as well as pain in the left forearm pinhole, by Atrial fibrillation management mobile app software “Guidance on alfalfa anticoagulation”. Following the diagnosis of warfarin-induced skin ulceration, the patient received intravenous vitamin K and fresh frozen plasma (FFP) to reverse the effects of warfarin. After 3 days of effective treatment, the patient 's forearm ulceration improved and healed soon. This case highlights the importance of telemedicine in patients with anticoagulant therapy. And warfarin should be used with caution in patients with HIT, HIT antibodies detection should be requested in patients presenting with thrombocytopenia after using of heparin. We suggest that medical staff should provide the remote medical and remote drug monitoring for patients with chronic diseases and those taking high-risk drugs. |
| first_indexed | 2024-03-11T03:13:30Z |
| format | Article |
| id | doaj.art-76e1bcb33dd14da0b8a7297aeb3da222 |
| institution | Directory Open Access Journal |
| issn | 2588-9141 |
| language | English |
| last_indexed | 2024-03-11T03:13:30Z |
| publishDate | 2023-12-01 |
| publisher | KeAi Communications Co., Ltd. |
| record_format | Article |
| series | Clinical eHealth |
| spelling | doaj.art-76e1bcb33dd14da0b8a7297aeb3da2222023-11-18T04:29:26ZengKeAi Communications Co., Ltd.Clinical eHealth2588-91412023-12-016144146Pharmacological analysis and remote monitoring of a patient with skin ulcers caused by anticoagulationWu Ling0Zhou Ru1Ji Peiying2Haibing Yang3Geng Wenye4Su Qiongli5Department of Pharmacy, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, Hunan, ChinaDepartment of General Surgery, RuiJin Hospital LuWan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Pharmacy, Kong Jiang Hospital Of Yangpu District, Shanghai, ChinaDepartment of Cardiovascular Internal Medicine, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, Hunan, ChinaFudan Zhangjiang Institute, Shanghai Medical College of Fudan University, Fudan University, Shanghai, ChinaDepartment of Pharmacy, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, Hunan, China; Corresponding author.A woman in her 76 s has valvular heart disease, atrial fibrillation, and myelodysplastic syndrome. Warfarin bridged with low molecular weight heparin (LMWH), was treated for anticoagulation therapy in this patient. Five days later, The patient informed the anticoagulant management personnel from the APP of abnormal coagulation, thrombocytopenia, and ulcers, as well as pain in the left forearm pinhole, by Atrial fibrillation management mobile app software “Guidance on alfalfa anticoagulation”. Following the diagnosis of warfarin-induced skin ulceration, the patient received intravenous vitamin K and fresh frozen plasma (FFP) to reverse the effects of warfarin. After 3 days of effective treatment, the patient 's forearm ulceration improved and healed soon. This case highlights the importance of telemedicine in patients with anticoagulant therapy. And warfarin should be used with caution in patients with HIT, HIT antibodies detection should be requested in patients presenting with thrombocytopenia after using of heparin. We suggest that medical staff should provide the remote medical and remote drug monitoring for patients with chronic diseases and those taking high-risk drugs.http://www.sciencedirect.com/science/article/pii/S2588914123000278AnticoagulantTelemedicineDrug monitoringSkin ulceration |
| spellingShingle | Wu Ling Zhou Ru Ji Peiying Haibing Yang Geng Wenye Su Qiongli Pharmacological analysis and remote monitoring of a patient with skin ulcers caused by anticoagulation Clinical eHealth Anticoagulant Telemedicine Drug monitoring Skin ulceration |
| title | Pharmacological analysis and remote monitoring of a patient with skin ulcers caused by anticoagulation |
| title_full | Pharmacological analysis and remote monitoring of a patient with skin ulcers caused by anticoagulation |
| title_fullStr | Pharmacological analysis and remote monitoring of a patient with skin ulcers caused by anticoagulation |
| title_full_unstemmed | Pharmacological analysis and remote monitoring of a patient with skin ulcers caused by anticoagulation |
| title_short | Pharmacological analysis and remote monitoring of a patient with skin ulcers caused by anticoagulation |
| title_sort | pharmacological analysis and remote monitoring of a patient with skin ulcers caused by anticoagulation |
| topic | Anticoagulant Telemedicine Drug monitoring Skin ulceration |
| url | http://www.sciencedirect.com/science/article/pii/S2588914123000278 |
| work_keys_str_mv | AT wuling pharmacologicalanalysisandremotemonitoringofapatientwithskinulcerscausedbyanticoagulation AT zhouru pharmacologicalanalysisandremotemonitoringofapatientwithskinulcerscausedbyanticoagulation AT jipeiying pharmacologicalanalysisandremotemonitoringofapatientwithskinulcerscausedbyanticoagulation AT haibingyang pharmacologicalanalysisandremotemonitoringofapatientwithskinulcerscausedbyanticoagulation AT gengwenye pharmacologicalanalysisandremotemonitoringofapatientwithskinulcerscausedbyanticoagulation AT suqiongli pharmacologicalanalysisandremotemonitoringofapatientwithskinulcerscausedbyanticoagulation |