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afya
Warfarin
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> Inhibits reduction of vit K to active hydroquinone which is co-factor in carboxylation of factors 2,7 9 10 and protein C ''Indications'' VTE - target 2.5 unless recurrent then 3.5 AF - target 2.5 Mechanical heart valves - depends on type and location (mitral >aortic) Monitour with INR - ratio of prothrombin of pt cf normal prothrombin takes 3 days to stabilize ''Potentiating factors'' liver disease P450 inhibitors - amiodarone, ciprofloxacin cranberry juice NSAID - displace warfarin from albumin and inhibit platelets ''SE'' Haemorrhage teratogenicity (can be used for breast feeding) skin necrosis (protein C reduced which gives pro-coagulant effect, avoided by also giving heparin. small thromboses in venules may cause skin necrosis) purple toes
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slimindex, index, CVSdrugs, Thrombophylaxis