Clinicians also consider how quickly and to what extent the anticoagulation needs to be reversed. Which option to use depends mainly on the severity of a patient’s bleeding, or risk of bleeding, at the time of treatment. Prothrombin complex concentrates (PCC).

The treatment options for patients who have been over-anticoagulated are: Before vitamin K is administered, the potential for warfarin resistance must be balanced against the risk of bleeding - determined according to the patient’s indication for anticoagulation. Overenthusiastic use of vitamin K can cause warfarin resistance when anticoagulation is restarted, which exposes a patient to an increased risk of thrombosis. Oral anticoagulants are, therefore, considered to be a significant potential risk to patient safety. Studies suggest that nearly 1% of haemorrhage cases are fatal 2. The precise incidence of haemorrhage due to excessive anticoagulation is difficult to measure, possibly due to variance in how bleeding is classified when treated in different clinical settings. Warfarin use is associated with an increased risk of haemorrhage. It also helps to understand the subsequent care of patients who have undergone warfarin reversal treatment. Nonetheless, pharmacists may need to refer patients for treatment to reverse over-anticoagulation, so a clear understanding of how such patients are managed is essential. While pharmacists often monitor their patients’ INRs, it is usually doctors who manage patients who have become over- anticoagulated. They are also used to treat current DVTs or pulmonary emboli.Īppropriate management of warfarin therapy requires monitoring of patients’ international normalised ratios (INRs). They are used for several indications, including thromboprophylaxis for patients with atrial fibrillation, or who have undergone a mechanical heart valve replacement or had deep vein thrombosis (DVT). Oral vitamin K antagonist anticoagulants (eg, warfarin sodium) are prescribed for around 500,000 patients in the UK at any one time 1.

We do not recommend that you take any clinical decisions based on this information without first ensuring you have checked the latest guidance. Journal of Pharmaceutical Health Services Research.

International Journal of Pharmacy Practice.

Antimicrobial resistance and stewardship.

Antidote for coumadin overdose