These patients can usually be managed without hospital referral, by simple warfarin dose omission. Most often, the patient is asymptomatic and there is no sign of active bleeding. Warfarin reversal in non-bleeding patientsĪ common scenario is the discovery of an elevated INR on a routine INR monitoring check. The speed and completeness of reversal required depends on the individual clinical circumstances. Use of PCCs has replaced the use of fresh frozen plasma, which is a less effective way of reversing warfarin. This is most often done by IV administration of a prothrombin complex concentrate (PCC), which contains the vitamin K-dependent clotting factors. Warfarin can be reversed by the administration of vitamin K or replacement of vitamin K-dependent clotting factors. The anticoagulant effect of warfarin results from the inhibition of the gamma-carboxylation step in the synthesis of the vitamin K-dependent clotting factors II, VII, IX and X. One advantage of warfarin is that its mechanism of action is easy to reverse when the need arises, because of the way it works. But it may also occur when the INR is in the target range. The risk of bleeding increases when the patient is over-anticoagulated. The only major side-effect of warfarin is bleeding. 1Īll patients who are receiving warfarin need to be monitored, with regular checks of the INR. However, there are challenges in the management of patients taking warfarin, which have been highlighted in a National Patient Safety Agency safety alert. Warfarin treatment is safe and effective for most patients. It is possible that newer anticoagulants will replace warfarin in the future, but until these are widely available, warfarin is the anticoagulant of choice. In recent years, there has been a dramatic increase in the number of patients receiving long-term anticoagulation with warfarin. 0.5 CPD Credits Click here to reflect on this article and add notes to your CPD Organiser on MIMS Learning
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |