Warfarin

Question 1

CI

Answer 1

Pregnancy - teratogenic
Sig risk of major bleeding
Active bleeding
avoid use within 48h postpartum/ haem stroke/ sig bleeding

Question 2

How tx works

Answer 2

Blocks vit K - vit K needed by body to make proteins that cause blood to clot, therefore thins blood to treat/ prevent blood clots

Question 3

Tx course and how its taken

Answer 3

OD PM around same time each day - preferably on empty somach washed with full glass of water
Depends on cause - DVT/ PE depends on cause can be 3/6 mo / AF lifelong
Dose changes take 2-3 days to take effect

Question 4

Monitoring

Answer 4

Regular blood test w/ INR (international normalised ratio) at either GP or anicoag clinic - regularity det by INR stability
Dose needed depends on INR - varies for each person
Will be given warfarin anticoagulation (yellow) booklet - record warfarin info and bring/ show to HCP as many interactions

Achieving stable INR may take several days as long half life

Question 5

SE

Answer 5

Will bruise easily when on warfarin and bleeding take longer to stop - but apply pressure should stop it

Teratogenic - need to tell Dr if think pregnant (but can be used in breastfeeding mothers)

Bleeding - seek med advice if sig HI, prolonged nose bleed (>10mins??), unusual headaches, blood in urine/ stool/ sputum/ vomit/ black stool, unexplained + severe bruising, severe bleeding gums

Rare/ v rare - hair loss, nausea, V

Many interactions (P450 inhib/induc)
AVOID liver, spinach, cranberry juice, alcohol binges, NSAIDs/ aspirin, grapefruit juice, mango juice, mangoes, seville oranges