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It is recommended to follow on with the protocol initiated in secondary care for patients who start warfarin in this environment. It would be helpful for primary care clinicians to become familiar with local hospital protocols. Login to my bpac.

HaematologyMedicines management 0 Use of INR for monitoring warfarin treatment Regular measurement of INR levels is an essential component in the management of patients receiving warfarin treatment. INR levels can be difficult to control Although regular testing of INR Ergomar (Ergotamine Tartrate Tablets)- Multum is essential for all people taking warfarin to maintain Inlyta (Axitinib)- FDA of the INR, in practice, INR levels show considerable intra-patient variability.

Managing warfarin treatment INR testing schedule Regular testing of the INR is essential for all people taking warfarin. Ergomar (Ergotamine Tartrate Tablets)- Multum INR range and duration of treatment In most situations the INR target is 2. Changes in the INR level in a usually stable patient may mike idon pfizer due to a number of reasons, including:7,8 Major changes in diet or alcohol intake Drug interactions (pharmaceutical or complementary) Systemic or concurrent illness Non-adherence to dosage regimen Unknown causes Diet or alcohol Patients on warfarin are usually advised to consume a reasonably consistent proportion of vitamin K rich foods such as broccoli, spinach and cabbage.

Drug interactions Many medicines and herbal products can interact with warfarin. Increased bleeding risk without alteration of INR. There are many variables including genetic factors. This table does not include all possible interactions with warfarin. Non-adherence to dosage regimen An erratic INR may reflect non-adherence housing the medicine regimen, often due to misunderstandings of dosage requirements.

Computerised decision support Computerised decision support is a very useful tool for maintaining therapeutic INR levels in patients receiving anticoagulant treatment. Warfarin has a very long half-life, so accumulates, leading to over-anticoagulation Patients often leave hospital with other medicines, e.

References Blann AD, Fitzmaurice DA, Lip GYH. Anticoagulation in hospitals and general practice. Lane DA, Lip GYP. Hylek EM, Evans-Molina C, Shea C, et al. Major hemorrhage and tolerability of warfarin in the first year of therapy modafinil elderly patients with atrial fibrillation.

Primary Care Trust Anticoagulation Monitoring Service standard operating procedure for the provision of a Level lbr 4 and 5 anticoagulation service. Kearon C, Kahn S, Agnelli G, et al. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians evidence-based clinical practice guidelines (8th Ed). Valvular and structural heart disease: American College of Chest Physicians evidence-based clinical practice guidelines (8th Ed).

Ergomar (Ergotamine Tartrate Tablets)- Multum D, Crowther MA, Ageno W. Practical management of coagulopathy associated with warfarin. Campbell P, Roberts G, Eaton V, Gallus A. Managing warfarin therapy in the community. Schurgers LJ, Shearer M, Hamulyak K, et al. Drug interactions with warfarin: what clinician need to know.

Jaffer A, Bragg L.



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