warfarin and high INR Flashcards
1
Q
Mx if major bleeding
A
stop warfarin
give IV VitK 5mg
prothrombin complex concentrate, or FFP if not available
2
Q
minor bleeding
INR >8
A
stop warfarin
give IV VitK 1-3mg
repeat dose VitK if INT too high over 24hrs
restart warfarin when INR<5
3
Q
INR >8.0
no bleeding
A
stop warfarin
give VitK oral 1-5mg
repeat dose vitK if INR too high after 24hrs
restart when INR <5
4
Q
INR 5-8
minor bleeding
A
stop warfarin
give IV VitK 1-3mg
restart when INR <5
5
Q
INR 5-8
no bleeding
A
withhold 1 or 2 doses of warfarin
reduce subseqent maintenance dose
