Monitoring and Evaluation of Herb-Drug Interactions in Outpatient Service - A Pilot Study of taking Warfarin with Traditional Chinese Medicine

• Main Authors: Yung Te Kuo, 郭永德
• Other Authors: H. K. Chang
• Format: Others
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/55746703169456947357

碩士 === 長庚大學 === 管理學院碩士學位學程在職專班資訊管理組 === 100 === Concomitant administration of Western and Traditional Chinese Medicines (TCM) that may result in decreased efficacy or adverse reactions has long been of great clinical concern. Yet with few relevant literature available, systemic analyses of these concomitant uses is due and necessary. Owing to this, a well-organized, systematic study collecting cases of herb-drug interactions in Taiwan is urgently needed to analyze and assess the incidence of adverse drug reactions in combined Chinese and western medication uses. In the pilot study, patients concurrently were taking warfarin with Traditional Chinese medicines simultaneously in our outpatient services. On the one hand retrospective review our patients’ data from 2008 to 2010 and the other hand to intensive monitoring the patients’ interaction from January to October in 2011. In the retrospective review from 2008 to 2010, 305 outpatients were found to have combined warfarin and Chinese medicine. The longest term was 673 days since use formula. The dosage of warfarin was 2.77 ±1.56mg/day and the International Normalized Ratio (INR) was 1.911 ±0.7042. Of the 54 people that combined Radix Salviae Miltiorrhizae. Neither paired t-Test analysis warfarin with traditional Chinese medicine or Wilcoxon signed rank test analysis of warfarin with Radix Salviae Miltiorrhizae, the INR expressed no remarkable. In this study and reference review, there was no consistence between warfarin with Radix Salviae Miltiorrhizae and literature review. In intensive monitoring study from January to October in 2011, 128 outpatients were found to have combined warfarin and Chinese medicine. The longest term was 231 days since use formulas. There were only 3 possibly-related adverse drug reaction cases in this study. Of the 31 people that combined warfarin and Radix Salviae Miltiorrhizae. Only one case was possibly-related adverse drug reaction in herb-drug interaction. During duration of taking warfarin with Traditional Chinese Medicine, there were 13 outpatients showed the INR over 3.5. Only 1 cases show possibly-related adverse drug reaction. According to the concept of Pharmacovigilance, we should exploit information technology to set up an Intensive Monitoring System for herb-drug interactions. Monitor and assess the reciprocation of the drug interaction in medical clinic for a long term program. Try to find, warn and predict the adverse drug reactions of the Chinese and Western medicine interaction in early days. All these were for improving the patients’ drug safety.