Warfarin

Question 1

Takes up to ? days to have an effect on clotting factor levels, and has an
initial ? effect so should always be combined with a ? agent until ? is within the therapeutic range.

Answer 1

5
prothrombotic
heparin
INR

Question 2

Contraindicated in ? ? disease, ? disorders, severe ? and ?.

Answer 2

pud
bleeding
hypertension
preg

Question 3

Target INRs for prophylactic use

Single DVT / PE: ?-?
Atrial fibrillation: ?-?
Recurrent DVT / PE: ?-?
Prosthetic metal heart valves: ?-?

Answer 3

2-3
2-3
3-4
3-4

Question 4

When starting warfarin, a ? dose is given with INR measured on ? days, and dose titrated according to ?.

Answer 4

loading
alternate
INR

Question 5

Over anticoagulation with warfarin.

Take INR;
If ?-?, reduce dose of warfarin or omit dose, restart when INR .
If ?-?, stop warfarin, restart (at a ? dose) when INR .

Answer 5

4.5-6
5
6-8
lower
5

Question 6

Over anticoagulation with warfarin.

If >? with no bleed / a minor bleed, ? warfarin.
—0 Also give ?-?mg ? vitamin K if risk factors for bleeding.

Answer 6

8
stop
0.5-2

Question 7

If major bleed, ? warfarin, give ?-?mg vitamin K ?, plus ? (combination of vitamin K dependant clotting factors) or ? according to local guidelines.

Answer 7

stop
5-10
IV
octaplex 
FFP

Question 8

? ? can take several ? to work, so is not sufficient in an ? bleed.

Answer 8

vit k
hours
acute