Warfarin monitoring guidelines
Common Questions and Answers about Warfarin monitoring guidelines
jantoven
I have been taken off Warfarin, prescribed after surgery. I possess 14 2.5mg tablets. What is the safest way for me to dispose of them?
Also, remember that although warfarin (coumadin) is cheaper for the pills, it also requires huge amounts of monitoring. During the start of warfarin your wife will have to go to the anti-coagulation clinic every 4-7 days for them to stabilize her dose. After that every month and only after she is stable for a long time could it be every 3 months. These visits come with their co-pays and deductibles too! Not to mention that warfarin has significant risks, drug interactions, food restrictions etc.
The protocol guidelines are aspirin and plavix for year or a little longer if the implant was DES. Drug enduced stents have propensity to form a clot when compared to bare metal stents.
After a year the consensus is to continue aspirin (81mg is OK), and unless there is a special need for an additional anti-platelet medication the plavix should be discontinued based on the risk of uncontrolled bleeding, etc. is greater than any benefit.
continue warfarin therapy, withhold warfarin therapy for a period of time before and after the procedure, or temporarily withhold warfarin therapy and also provide a "heparin bridge" during the perioperative period. Which management option to follow is primarily determined by the characteristics of the patient and by the nature of the procedure.
wow. I very upset I attacked the very foundation. It was called " wake up" it was a dicussion on the healthcare system. N meds for meds is not the way to go. I stated that measuring ceratonin n dopeamien was a theory. They have no way to measure ur levels.
My specialist has feferred me for an ablation procedure which I am waiting for now. I was put on warfarin and bisoprolol and due to the nature of my work I cannot go back whilst on warfarin as i work offshore. I was wandering why I cant be put on asprin which will at least allow me to pass my medical to return to work after the ablation. I have been off work for 3 months due to this and without pay which is causing me a great deal of stress and anxiety.
Futher to discussion re warfarin & eyebleeds (bleeds in eye), I have fairly frequent eybleeds which I find rather scary! The bleed usually continues for at least 2 days & takes over a week to clear. They have become worse & more frequent since I started on warfarin 2005. My INR tends to fluctuate & on 17/12/08 was 2.37. My current warfarin dose is 8 mg daily. Does this problem get worse over time?
My son has been on warfarin since he was 7 weeks old due to having a mechanical Mitral valve replacement. His INR today is 4.8. The highest it's ever been.He is six months now and just starting solids which may be why the INR has been all over the place. I have been instructed to withhold his dose tonight and I'll test him again tomorrow. I've been doing some reading that INR of 4.8 is undesirable but not overly dangerous. Is that the case for babies as well?
- why a clot should form in my heart when the muscles were damaged six years back and considering that I am on aspirin+clopidogrel which too have anti clotting function.
- warfarin may be slightly better as compared to aspirin+ clopidogrel, but in my case with no AF, does it makes sense getting into this risky business of conatantly monitoring of INR and fear of bleeding.
- I have seen on net some other drugs in market which are equally good as warfarin with lower risk of bleeding.
Im recently diagnosed with A-Fib and am sheduled for an electro-cardioversion next week (after 4 weeks warfarin therapy). The cardiologist wants to start me on Sotalol 3 days before on an outpatient basis. I've read where Sotalol should only be started in a closely monitored hospital setting for 3 days. (WebMD, NIH.gov, others..), and tells me this is common practice.
I would appreciate hraing from others on Sotalol as to how their dosage was started..
I am so sorry for your and your father's loss. That's terrible. I don't have a pacemaker, but I have heard that people with pacemakers have to worry about clots building up around the site of the pacemaker. My father-in-law has an implanted defibrillator and he takes coumadin. I don't think everyone who takes it will necessarily get the GI bleeding.
The basic rule is all patients with a valve replacement are initiated on anticoagulants namely warfarin to prevent the formation of the clots. He needs constant monitoring with PT INR test. It is usually recommended to have an INR of 2.0 to 3.0 for basic "blood-thinning" needs. If the INR is higher - about 2.5 to 3.5, it means it is more thinner to prevent clotting. If lower it is thicker.
And strokes can be ischemic or haemorrhagic.
hi st142 , I assume DVR stands for "Double Valve Replacement"; the fact that you are on Warfarin and monitoring your PT/INR indicates that you are on therapy to prevent embolism from a mechanical/bio-prosthetic valve in the heart.
While you are on Warfarin - and this would be life-long for you - you are at risk from both under-dosing, which would lead to embolism, and over-dosing, when you could have bleeding from some part of your body, including the brain.
Enhanced hypoprothrombinemic response to warfarin has been reported in patients with acute alcohol intoxication and/or liver disease. The proposed mechanisms are inhibition of warfarin metabolism and decreased synthesis of clotting factors. Binge drinking may exacerbate liver impairment and its metabolic ability in patients with liver dysfunction. The risk of bleeding may be increased. Conversely, reductions in INR/PT have also been reported in chronic alcoholics with liver disease.
Also, there are National Guidelines for the diagnosis and treatment of this condition and your doctors should refer to them and adhere to them.
Good luck.
12 year referred to him from the gastrologist with irregular heart beats. had many test lots of event monitoring wearing. Cardioevent not sure here the name 24/7 monitoring. Both the cardio nurse and the doctor said paroxsmal AF. treated me with rythmal was unable to tolerate it am on warfarin. EP mention a loop monitor. Im so discourage I'm ready to say forget it I'll just stay sick. Any ideas what to do next please help.
A person on warfarin with an inr of 1.2 is not at risk of bleeding out. They are at risk for a clot. People not on warfarin normal range of about 1 because they don't have a bleeding or clotting disorder, thus 1 is normal.
I take 10 MG a day everyday and my inr was 2.2 just today. It all depends o. The reason behind taking it.
Regarding antithrombotic therapy in the setting of atrial fibrillation, the guidelines recommend this for all patients with AF, except those with lone AF or contraindications.
The selection of the antithrombotic agent is usually based on the absolute risk of stroke and bleeding and the relative risk and benefit for a given patient. Based on the level of risk, most patients are either started on aspirin or Warfarin (Coumadin).
A very informative article/study that explains Fibroscan and its scores, compares it with Biopsy, gives monitoring guidelines for both HBV and HCV and summarizes many important studies findings. I found it very informative and useful. Here is the link below:
http://www.intmedpress.com/serveFile.cfm?
No, according to all international guidelines. Still require regular monitoring, at least yearly. Your numbers are very good.
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