Drug
Aliases:
Topic aliases are alternate phrasings for a particular topic.
Coumadin
Marevan
1
Vitamin K antagonist inhibiting the production of vitamin K dependent clotting factors II, VII, IX, and X. Indicated for therapeutic anticoagulation. Reversal is achieved through either witholding ~5days prior to elective surgery, with or without alternative short-duration anticoagulation, or reversed closer to surgery with prothrombinex, FFP, and vitamin K.
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Sep 13, 2011
Intramuscular or subcutaneous vitamin K1 for reversal of warfarin is not recommended as it exhibits depot characteristics that may interfere with recommencement of anticoagulation therapy. Furthermore, intramuscular injection in patients on anticoagulation therapy (particularly when over-anticoagulated) poses a significant risk of haematoma formation.
Studies have also shown that the response to intramuscular or subcutaneous vitamin K1 is unpredictable and sometimes delayed.
refl.in/i4
Studies have also shown that the response to intramuscular or subcutaneous vitamin K1 is unpredictable and sometimes delayed.
refl.in/i4
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Dec 03, 2012
Warfarin is contraindicated in pregnancy refl.in/2a . Warfarin embryopathy occurs in approximately 5% of fetuses exposed to warfarin between 6-13 weeks. Warfarin embryopathy is variable in severity and ranges from mild nasal flattening to severe mid face flattening with shortened limbs (dwarfism). Exposure in the second or third trimester carries an additional 5% risk of fetal intracerebral haemorrhage.
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Dec 10, 2011
Day of surgery: If INR < 1.5 most surgery can generally proceed, but may need to discuss with surgeon. If INR > 1.5, defer surgery, or if surgery is urgent, give Prothrombinex HT (25–50 IU/kg) plus 150–300 mL fresh frozen-plasma or 10–15 mL/kg of fresh frozen-plasma if Prothrombinex-HT is not used. refl.in/i4
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Recommencing warfarin:
If no risk factors exist and the patient has a previous known stable dose of Warfarin, Recommence on the same dose that the patient previously had a stable therapeutic INR, assuming that no new risk factors exist.
No “loading” dose is required in this situation. refl.in/ob
If no risk factors exist and the patient has a previous known stable dose of Warfarin, Recommence on the same dose that the patient previously had a stable therapeutic INR, assuming that no new risk factors exist.
No “loading” dose is required in this situation. refl.in/ob
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Dec 03, 2012
Warfarin reversal guidelines by the Australasian Society of Thrombosis and Haemostasis 2004 refl.in/i4
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Sep 13, 2011