Diagnosis and treatment of warfarin resistance.
10.3969/j.issn.1672-7347.2013.03.016
- Author:
Shenglan TAN
1
;
Xinmin ZHOU
;
Zhi LI
;
Wei ZHANG
;
Zhaoqian LIU
;
Honghao ZHOU
Author Information
1. Institute of Clinical Pharmacology, Central South University, Changsha 410078, China.
- Publication Type:Journal Article
- MeSH:
Anticoagulants;
pharmacology;
Drug Monitoring;
methods;
Female;
Humans;
International Normalized Ratio;
Male;
Metabolism, Inborn Errors;
diagnosis;
etiology;
genetics;
Vitamin K;
administration & dosage;
Vitamin K Epoxide Reductases;
genetics
- From:
Journal of Central South University(Medical Sciences)
2013;38(3):313-317
- CountryChina
- Language:Chinese
-
Abstract:
Warfarin resistance is a phenomenon that patients need to take much higher than normally prescribed dosage of warfarin to maintain the target therapeutic international normalized ratio (INR) range, or even fail to reach the target INR. Warfarin resistance can be categorized in etiologic terms as hereditary vs acquired, or in pharmacologic terms as pharmacokinetic vs pharmacodynamic. Once warfarin resistance is diagnosed, the type of resistance should be determined as soon as possible so that treatment could be oriented toward the causes. Poor compliance, genetic mutations, concurrent medications that could decrease the absorption or increase the clearance of warfarin, and consumption of diet rich in vitamin K are the major reasons for warfarin resistance. Educating patients, increasing warfarin dosage and switching to other anticoagulants would be effective for warfarin resistance.
