Warfarin: A Comprehensive Review - UConn Health
Warfarin: A Comprehensive Review
Jay M Patel, PharmD
Objectives
? Explain the important pharmacodynamic and pharmacokinetic properties of warfarin
? Describe the role of warfarin in the inpatient setting
? Identify factors that may contribute to variability in the INR with warfarin use
? Discuss warfarin initiation and dose adjustments based on a comprehensive review of the patient
Disclaimer
Dr. Patel has no actual or potential conflict of interest associated with this presentation
Coumadin? (Warfarin)
? Clinical Pharmacology
? Inhibit synthesis of Vitamin K dependent clotting factors
? II, VII, IX and X ? Protein C and S
? Mechanism of Action
? "Vitamin K antagonist" (VKA) ? Inhibit C1 subunit of vitamin K epoxide
reductase (VKORC1) enzyme complex
Coumadin? (Warfarin)
? Elimination half-lives of vitamin Kdependent proteins
Factor II VII IX X Protein C Protein S
Half-Life 42-72 hours 4-6 hours 21-30 hours 27-48 hours 8 hours 60 hours
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