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KMID : 0941820100200010085
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Korean Journal of Clinical Pharmacy
2010 Volume.20 No. 1 p.85 ~ p.87
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Early-stage Diagnosis of Bladder Carcinoma by a Clinical Pharmacist’s Effective Anti-coagulation Service in a Patient with Anticoagulation Anticoagulation
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An Sung-Sim
Bang Joon-Seok
La Hyen-O
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Abstract
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Recently, the prevalence of bladder cancer is increasing in the Korean society. As the risk factors of bladder carcinoma are variable, the early-stage diagnosis is regarded the best preventive practice. Hematuria is a specific sign of the malignancy as well as a kind of various medication-related adverse reactions. Some anti-coagulation therapy can cause bleedings including hematuria to the patients with cardiovascular diseases such as paroxysmal atrial fibrillation (PAF). Therefore, to the clinical pharmacists working in the anti-coagulation services (ACS), a closer monitoring of patients can give an opportunity to find certain ailments unexpectedly. In this case, a patient with PAF had episodes of sporadic hematuria in the course of warfarin therapy even though with its low levels of INR. An ACS pharmacist found a discrepancy between the bleeding symptoms and INR values, and recommended properly the patient to refer urologist. Fortunately, an early-stage of bladder carcinoma was found then followed by an excision performed to the lesion. Therefore, alert-minded and precise monitoring done by ACS pharmacist could optimize the therapeutic outcomes as well as increase the quality of life of the patient.
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KEYWORD
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bladder carcinoma, hematuria, anticoagulation, warfarin, INR, ACS
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