Key result
Pharmacotherapy in a post-PTCA unstable angina patient improved creatinine from 1.5 to 1.1 mg/dL and urea from 28 to 15 mg/dL, despite subtherapeutic doses of enoxaparin, ranitidine, and lactulose.
Why the study?
This case study sought to evaluate pharmacotherapy appropriateness, identify potential drug-related problems, and provide rational therapy recommendations for a patient with UAP post-PTCA and multiple comorbidities including stage 1 AKI.
Case Report (n=1)
No
This case report highlights the importance of clinical pharmacist medication reviews in identifying dosing discrepancies and managing bleeding risks from antithrombotic interactions in a complex post-PTCA patient with acute kidney injury.
Answers are grounded in this paper and cite their sources.
Pharmacist review may mitigate bleeding risk in post-PTCA triple therapy; case-level data leaves open dosing effects on renal recovery in unstable angina.
This case study aimed to evaluate the appropriateness of pharmacotherapy, identify potential Drug Related Problems (DRPs), and provide rational therapy recommendations for a patient with UAP post PTCA 1 stent, controlled hypertension, dyspepsia syndrome, and Acute Kidney Injury (AKI) stage 1 dd acute on Chronic Kidney Disease (CKD). A descriptive method with a case study design was applied to a 53-year-old male patient hospitalised in the Cardiac Ward of RSUP Dr. M. Djamil Padang. Data were collected prospectively through interviews, clinical observation, and medical record review, then evaluated based on the right indication, right patient, right drug, and right dose criteria and compared with clinical guidelines. The results showed that the therapy, comprising antiplatelet, anticoagulant, statin, nitrate, antihypertensive, gastrointestinal, and supportive agents, was generally appropriate. However, several potential DRPs were identified, namely lower-than-reference doses of enoxaparin, ranitidine, and lactulose, as well as pharmacodynamic interactions among acetosal, clopidogrel, and enoxaparin that increase bleeding risk. During follow-up, the patient's clinical condition and renal function improved, indicated by a decrease in creatinine from 1.5 to 1.1 mg/dL and urea from 28 to 15 mg/dL. Pharmacist involvement in medication review is essential to optimise therapeutic effectiveness and safety.
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Ningsih et al. (2026) conducted a case report in Unstable Angina Pectoris (UAP) post PTCA, controlled hypertension, dyspepsia syndrome, and Acute Kidney Injury (AKI) stage 1 on Chronic Kidney Disease (CKD) (n=1). Pharmacotherapy regimen (antiplatelets, anticoagulants, statins, nitrates, antihypertensives, gastrointestinal and renal supportive agents) and clinical pharmacist medication review vs. Clinical guidelines (PERKI, DiPiro, drugs.com, Medscape) was evaluated on Appropriateness of pharmacotherapy, Drug Related Problems (DRPs), and clinical/renal function improvement (serum creatinine and blood urea). Pharmacotherapy in a post-PTCA unstable angina patient improved creatinine from 1.5 to 1.1 mg/dL and urea from 28 to 15 mg/dL, despite subtherapeutic doses of enoxaparin, ranitidine, and lactulose.
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