Study: Doctors often make dosing errors for anti-clotting drugs

SCRIPPS HOWARD
AS MANY AS 42 PERCENT OF PATIENTS RUSHED TO HOSPITAL EMERGENCY ROOMS WITH SYMPTOMS OF A HEART ATTACK ARE GETTING THE WRONG DOSES OF POWERFUL DRUGS INTENDED TO STOP CLOTTING IN THE CORONARY ARTERIES, ACCORDING TO A NEW STUDY.
CARDIOLOGISTS FROM DUKE UNIVERSITY'S CLINICAL RESEARCH INSTITUTE SAY IT APPEARS EMERGENCY ROOM DOCTORS OFTEN DON'T CAREFULLY CONSIDER CRITICAL TRAITS SUCH AS PATIENT'S WEIGHT AND KIDNEY FUNCTION WHEN ORDERING THE DRUGS.
ALTHOUGH IT'S BEEN WELL-ESTABLISHED IN CLINICAL TRIALS OVER THE YEARS THAT THE ANTI-CLOTTING DRUGS CAN SAVE LIVES, GETTING THE DOSE RIGHT FOR AN INDIVIDUAL PATIENT IS VITAL, SINCE TOO HIGH A DOSE CAN LEAD TO BLEEDING EPISODES, WHILE TOO LOW A DOSE MAY BE INEFFECTIVE AT PREVENTING MORE CLOTS.
WIDESPREAD PROBLEM
"OUR ANALYSIS, WHICH INCLUDES PATIENTS TREATED IN ALL TYPES OF HOSPITALS ACROSS THE COUNTRY, SHOWS THAT DOSING ERRORS OCCUR MORE OFTEN IN VULNERABLE PATIENTS, SUCH AS WOMEN, THE ELDERLY, OR THOSE WITH KIDNEY INSUFFICIENCY OR LOW BODY WEIGHT," SAID DR. KAREN ALEXANDER, LEAD INVESTIGATOR OF THE STUDY PUBLISHED TODAY IN THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.
THEY STUDIED USE OF THREE COMMONLY PRESCRIBED HEART ATTACK DRUGS: UNFRACTIONATED HEPARIN, LOW-MOLECULAR-WEIGHT HEPARIN AND GLYCOPROTEIN INHIBITORS, WHICH WORK BY EITHER PREVENTING THE BUILDUP OF BLOOD PLATELETS IN THE HEART'S ARTERIES OR INTERFERING WITH THE FORMATION OF BLOOD CLOTS.
THE DRUGS ARE TYPICALLY GIVEN WITHIN THE FIRST 24 HOURS OF HEART ATTACK SYMPTOMS AND ARE OFTEN GIVEN IN COMBINATION. "THESE DRUGS ARE CLEARLY BENEFICIAL, AND WHEN DOSED CORRECTLY, ARE ALSO SAFE," DR. ALEXANDER SAID.