Warfarin Flashcards
Therapeutic INR range for mechanical heart valve
3-4
Therapeutic INR range for AF/ DVT/ PE
2-3
How long before surgery should warfarin be stopped
5 days prior
Low INR means warfarin is working better or worse
Low INR = Warfarin is not working as well
Is warfarin safe in breastfeeding
Yes. Safe in breastfeeding
Is warfarin safe in pregnancy
No. Not safe in pregnancy
What to do with patient on warfarin
Major bleed
Stop warfarin
IV Vit K (Phytomenadione)
Prothrombin complex
What to do with patient on warfarin
INR 9 and above
Minor beed
Stop warfarin
IV Vit K (Phytomenadione)
What to do with patient on warfarin
INR 5-8
Minor beed
Stop warfarin
IV Vit K (Phytomenadione)
What to do with patient on warfarin
INR <5
Minor bleed
Nothing. Look for underlying cause
What to do with patient on warfarin
INR 9 and above
No bleed
Stop warfarin
Oral Vit K (Phytomenadione)
What to do with patient on warfarin
INR 5-8
No beed
Withhold 1-2 doses warfarin.
Reduce subsequent doses.
How long must warfarin be bridged with LMWH for?
2 days
Which antibiotic has a very significant reaction with warfarin (to increase INR)
Metronidazole
Name enzyme inhibitors and their effect on warfarin
Enzyme inhibitors = reduced breakdown = increased drug concentration
= BLEED
AO DEVICES
Allopurinol Omeprazole Disulfiram (for chronic alcoholism) Erythromycin Valproate Isoniazid Ciprofloxacin Ethanol (acute) Suphonamides
Infection could give you reddish pee
Or valproate for Epilepsy
Allopurinol if you’ve got a bad knee
PPI for stomachs or cranberries
