07 warfarin Flashcards
Absolute Contraindications if warfarin? 4
The presence of a severe or active bleeding
diathesis
• Non-adherence to medication and INR monitoring
• Pregnancy28 (avoided at least during the first
trimester and from about 2 to 4 weeks before
delivery)
• Allergy or intolerance to warfarin (consider
warfarin alternative – Nicoumalone)
Some Relative Contraindications? 3
• Uncontrolled hypertension (> 160/100 mm Hg)
• Severe liver disease
• Recent surgery and procedures involving the
nervous system, spine or eye
is vit K giving orally or SQ safer? why?
IV vit K?
oral vit K
SQ absorption is unpredicted
IV vit K is most predictable - flushing, cp etc lots of reaction, only given in emergency and go slow
if pt allergic to warfarin, whats an alternative?
Nicoumalone (Sintrom)
is warfarin absorption impacted by food?
what type of blood produce is warfarin bound to?
what happends when there is less of it?
no
bound to albumin, if albumin deficient, should use less warfarin cuz it wont helpful if there is nothing to bind to
why it takes 5-7 days to be inr therapeutic
long half life of prothrombin
when in pregnancy not to use warfarin? what is better to use than warfarin?
first trimester and 2-4 weeks before delievery
unfractionated or low weight heparin