Praćenje pacijenata na oralnoj antikoagulantnoj terapiji u uslovima Kovid-19 pandemije

Medicinska reč 2022; 3(1): 10–13

https://doi.org/10.5937/medrec2201010A

Originalni rad

Ana Antić

Apstrakt

Iako rad ambulanti za praćenje antikoagulante terapije (AKA) nije bio u prvoj liniji prioriteta u uslovima širenja Kovid-19 pandemije, u sklopu odgovora celokupnog zdravstvenog sistema našla se i reorganizacija rada ove službe, a sve u cilju obezbeđenja najvišeg stepena kvaliteta praćenja terapije u uslovima pandemije. AKA su nastavile sa radom i u uslovima lokdauna i kampanje „Ostani kod kuće”, pružajući najviši kvalitet stručne podrške pacijentima, a uz obezbeđenje svih mera zaštite od transmisije virusa (dolazak bez pratnje, me­re­nje telesne temperature na ulazu, nošenje zaštitne maske, de­zinfekcija ruku alkoholom, fizička distanca). Pacijentima koji uzimaju antagoniste vitamina K (AVK) preporučena je upo­treba sopstvenih portabilnih aparata za kontrolu INR-a u kućnim uslovima.

Pacijenti koji uzimaju direktne oralne antikoagulanse (DOAK) ili AVK treba da nastave svoju prethodno propisanu terapiju, osim ako im transfuziolog, uzimajući u obzir terapiju koju uzimaju za lečenje kovid-19 infekcije, ne propiše drugačije. Kod pacijenata koji prethodno imaju dobro regulisan INR (TTR>60%) i u dobrom su opštem stanju, interval  do sledeće kontrole INR-a se produžava do 12 nedelja, a za sve pacijente, kod kojih je moguća primena DOAK-a, savetuje se prevođenje sa AVK na DOAK.

Vođenje antikoagulantne terapije treba biti zasnovano na principima rada u uslovima pre Kovid-19 pandemije u kom­binaciji sa racionalnim principima koji se uvode u na­sta­lim uslovima.

Ključne reči: kovid-19, antikoagulantna terapija, INR, varfrain, direktni antikoagulansi

Ceo tekst 

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