Warfarin Flashcards
What is the INR target for DVT/PE, MI and AF?
2.5
What is the INR target for recurrent DVT/PE?
3.5
If is INR above 8 and minor bleeding, what should you do?
Stop warfarin, start vit K (IV) and restart warfarin when INR is less than 5
Major bleeding, what should you do?
Stop warfarin, start vit K (IV) and dried prothrombin complex
INR is 5-8 and no bleeding
Stop warfarin, withhold 1-2 doses and reduce to maintenance dose
INR is 5-8 with minor bleeding?
Stop warfarin, vit K (IV) and restart warfarin when INR is less than 5
INR is above 8, but no bleeding?
Stop warfarin, give vit K orally and restart warfarin when INR is less than 5
How many days prior to elective surgery do you stop warfarin?
5 days
Delayed surgery (6-12 hours), what do you give?
IV Vit K to reverse anti-coagulant effect
Urgent surgery, what do you give?
IV Vit K and dried prothrombin complex
What affects INR levels?
Cranberry juice, leafy green veg, alcohol and St John’s Wort* (OTC)
