Vitamin K antagonists

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  1. drug:
    Warfarin (Coumadin)
  2. MOA:
    Inhibits the enzyme VKOR which then decrease the clotting factors 2, 7, 9, & 10
  3. kinetics:
    • Requires 2 to 3 days of treatment before anticoagulation takes effect
    • Warfarin can also inhibit or induce metabolism of other drugs
  4. Competitive antagonism with vitamin K:
    • foods containing vitamin K
    • (green leafy veggies)
  5. Dose:
    Start at 5 mg then monitor INR
  6. how is therapy monitored?
    using the International Normalized Ratio (INR)   on exam
  7. what is the INR goal?
    • 2-3(majority of ppl)
    • and 2.5-3.5 in patients with artificial heart valve ---
    • on exam
  8. CI
    • Pregnancy (teratogenic!!)
    • recent events that predispose to bleeding (stroke, surgery)
    • platelet disorders
  9. SE
    • Hemorrhage
    • Skin necrosis
    • Gangrene
    • “Purple toes” syndrome
    • Alopecia
    • Atheroemboli/cholesterol microemboli
  10. what is the fastest way to correct an overdose of warfarin?
    fresh frozen plasma
  11. what can you give when INR is too high?
    • Phytonadione (mephyton) 2.5-5 mg PO
    •    reverses anticoagulant effect of warfarin- vitamin K1
  12. significantgenetic variability in responses to warfarin owing to:
    to polymorphisms in 2C9 and VKOR
Card Set:
Vitamin K antagonists
2013-07-30 14:46:17
Vitamin antagonists

pharm- vitamin k antagonists
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