Warfarin Drug Counselling

benryan95's version from 2016-05-04 11:05


Question Answer
How does it work?It thins the blood, making blood clots less likely to happen, but bleeding more likely to happen
What are the benefits?It helps stop the formation of blood clots - which this patient is likely at risk of
What can it be given for?DVT, PE, AF, mechanical heart valve
How often is it taken daily?Once daily, usually in the evening, same time every day
How is it taken?It is a tablet, and a clinic will explain how much should be taken each day
how long is it taken for a distal DVT (according to NICE, niche knowledge?)6 weeks
How long is it taken for a proximal DVT with temporary, known risk factors?3 months
How long is it taken for an unprovoked proximal DVT?6 months
How long is it taken for a provoked PE?at least 3 months, but then reevaluated? (NICE just says 3 months)
How long is it taken for recurrent DVT/PE?Long term
How long is it taken for AF without cardioversion?Life long
How long is it taken for AF with cardioversion?Achieve INR 3 weeks before cardioversion and for 4 weeks afterwards
How long is it taken for mechanical heart valve?life long
Can it be stopped immediately once duration of course is completed?Yes
How long before an effect?3-4 days
How is it monitored (in detail!) after starting?INR measured daily/bi-daily until INR in therapeutic range --> INR twice weekly for 1-2 weeks --> weekly measurements to ensure still in range --> longer time between measurements e.g. 12 weeks
What is the target INR typically whilst on warfarin?2.5 (2-3)
What is the target INR for a mechanical heart valve?3-3.5
Where are INR checks documented?Yellow anticoagulation book
What are side effects of warfarin?Bleeding (tell doctor if unusual bleeding, dark stools also), nausea, vomiting, diarrhoea, rash. Rare but serious - skin necrosis
Drug interactionsCytochrome p450 inhibitors/inducers, steroids
Contraindicationspregnancy (warn patients about this), significant bleeding risk, caution with high fall risk
Avoidliver, spinach, cranberry juice, grapefruit juice and alcohol binges, OTC drugs without pharmacist/doctor approval, especially things containing ibuprofen, aspirin or other NSAIDs
SupplementaryGiven anticoagulation Book

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