Warfarin

Source: www.ncbi.nlm.nih.gov --- 10 days ago
Related Articles Factors in Warfarin therapy discontinuation. Arch Intern Med. 2008 Sep 22;168(17):1932; author reply 1933 Authors: Boos CJ, Marshall HJ PMID: 18809827 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 4 days ago
Related Articles Prospective study on Warfarin and regional chemotherapy in patients with pancreatic carcinoma. J Gastrointestin Liver Dis. 2008 Sep;17(3):285-290 Authors: Nakchbandi W, M Uuml Ller H, Singer MV, L Ouml Hr JM, Nakchbandi IA AIMS: The aim is to prospectively examine the effect of regional gemcitabine and mitomycin-C with systemic gemcitabine together with Warfarin in patients with inoperable pancreatic carcinoma, and compare the effect to systemic gemcitabine alone. METHODS: Seventeen patients received 1.25 mg of Warfarin daily, gemcitabine 800 mg/m² on day 1 and mitomycin-C 8 mg/m² on day 2 regionally and gemcitabine 800 mg/m² on day 14 peripherally. The cycle was repeated every 4 weeks. RESULTS: Median survival since presentation was 6.8 months, while median total survival was 9.6 months. Excluding the 3 patients who died before receiving any therapy, the median survival since presentation resulted in 10.7 months and the median total survival, 12.7 months. One patient developed bleeding that required transfusion and 2 patients developed anemia (Grades III/IV). Comparing these data to historical controls of large cohorts supports the notion that this regimen offers a viable alternative to systemic gemcitabine alone. CONCLUSION: A regimen consisting of regional gemcitabine and mitomycin-C with systemic gemcitabine and low-dose Warfarin compares favorably to the gold standard of systemic gemcitabine. These ...

Source: www.ncbi.nlm.nih.gov --- 10 days ago
Related Articles Warfarin therapy adjustment for oral surgery is an unnecessary risk. Arch Intern Med. 2008 Sep 22;168(17):1932; author reply 1933 Authors: Bayne D, Brennan PA PMID: 18809828 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 31 days ago
Related Articles Quality of anticoagulation and use of Warfarin-interacting medications in long-term care: a chart review. BMC Geriatr. 2008;8:13 Authors: Verhovsek M, Motlagh B, Crowther MA, Kennedy C, Dolovich L, Campbell G, Wang L, Papaioannou A BACKGROUND: Maintenance of therapeutic International Normalized Ratio (INR) in the community is generally poor. The supervised environment in long-term care facilities may represent a more ideal setting for Warfarin therapy since laboratory monitoring, compliance, dose adjustment, and interacting medications can all be monitored and controlled. The objectives of this study were to determine how effectively Warfarin was administered to a cohort of residents in long-term care facilities, to identify the proportion of residents prescribed Warfarin-interacting drugs and to ascertain factors associated with poor INR control. METHODS: A chart review of 105 residents receiving Warfarin therapy in five long-term care facilities in Hamilton, Ontario was performed. Data were collected on INR levels, Warfarin prescribing and monitoring practices, and use of interacting medications. RESULTS: Over a 12 month period (28,555 resident-days, 78.2 resident years) 3065 INR values were available. Residents were within, below and above the therapeutic range 54%, 35% and 11% of the time, respectively. Seventy-nine percent of residents were prescribed at least one Warfarin-interacting medication during the period ...

Source: www.ncbi.nlm.nih.gov --- 38 days ago
Related Articles Warfarin and pharmacogenomic testing: the case for restraint. Clin Pharmacol Ther. 2008 Sep;84(3):303-5 Authors: Garcia DA PMID: 18714318 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 38 days ago
The critical path of Warfarin dosing: finding an optimal dosing strategy using pharmacogenetics. Clin Pharmacol Ther. 2008 Sep;84(3):301-3 Authors: Lesko LJ PMID: 18714317 [PubMed - indexed for MEDLINE] ...

Source: www.moreover.com --- 24 days ago
-- Duloxetine was well tolerated when coadministered with Warfarin in healthy subjects and dose adjustment of Warfarin should not be required when duloxetine treatment is initiated in a patient on stable Warfarin therapy, researchers reported here at ...

Source: www.ncbi.nlm.nih.gov --- 37 days ago
Related Articles Integrating genomic based information into clinical Warfarin (Coumadin) management: an illustrative case report. Conn Med. 2008 Aug;72(7):399-403 Authors: LaSala A, Bower B, Windemuth A, White CM, Kocherla M, Seip R, Duconge J, Ruaño G Warfarin is a well established oral anticoagulant for the treatment of thromboembolic disorders. Warfarin therapy is complicated by a narrow therapeutic index and marked inter-individual dose variability with therapeutic doses ranging from 1 mg to 10 mg/day. Recently genetic variation and resultant drug metabolizing polymorphisms have been found to contribute to Warfarin dose variability with resultant hemorrhagic or thromboembolic complications. Cytochrome P4502C9 alters the rate of Warfarin metabolism and clearance. A second enzyme, Vitamin K Epoxide Reductase Complex (VKORC) binds and reduces Vitamin K which is necessary for activation of clotting Factors II, VII, IX and X. The VKORC1 gene encodes for Vitamin K Epoxide Reductase Complex subunit 1, a key component of VKORC. The combination of physiologic factors (30%), CYP2C9 variations (20%) and VKORC1 variants (25%) accounts for approximately 75% of Warfarin dose variability. This illustrative case report demonstrates the clinical importance of this new information. Clinicians need to incorporate these new genomic findings into appropriate management of Warfarin dose anticoagulation. PMID: 18763667 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 34 days ago
Related Articles Experimental Model of Warfarin-Associated Intracerebral Hemorrhage. Stroke. 2008 Sep 4; Authors: Foerch C, Arai K, Jin G, Park KP, Pallast S, van Leyen K, Lo EH BACKGROUND AND PURPOSE: Future demographic changes predict an increase in the number of patients with atrial fibrillation. As long-term anticoagulation for the prevention of ischemic strokes becomes more prevalent, the burden of Warfarin-associated intracerebral hemorrhage (W-ICH) is likely to grow. However, little is known about the clinical aspects and pathophysiologic mechanisms of W-ICH. This study describes the development of a mouse model of W-ICH in which hematoma growth and outcomes can be correlated with anticoagulation parameters. METHODS: CD-1 mice were treated with Warfarin (2 mg/kg per 24 hours) added to drinking water. ICH was induced by stereotactic injection of collagenase type VII (0.075 U) into the right striatum. Hemorrhagic blood volume was quantified by means of a photometric hemoglobin assay 2 and 24 hours after hemorrhage induction. Neurologic outcomes were assessed on a 5-point scale. RESULTS: The international normalized ratio in nonanticoagulated mice was 0.8+/-0.1. After 24 (W-24) and 30 (W-30) hours of Warfarin pretreatment, international normalized ratio values increased to 3.5+/-0.9 and 7.2+/-3.4, respectively. Compared with nonanticoagulated mice, mean hemorrhagic blood volume determined 24 hours after hemorrhage induction was fou ...

Source: www.ncbi.nlm.nih.gov --- 35 days ago
Related Articles Alternatives to Warfarin in atrial fibrillation: drugs and devices. Heart. 2008 Sep;94(9):1113-6 Authors: Bayard YL, Ostermayer SH, Sievert H PMID: 18703688 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 24 days ago
Related Articles Influence of thrombophilia on risk of recurrent venous thromboembolism while on Warfarin: Results from a randomized trial. Blood. 2008 Sep 12; Authors: Kearon C, Julian JA, Kovacs MJ, Anderson DR, Wells P, Mackinnon B, Weitz JI, Crowther MA, Dolan S, Turpie AG, Geerts W, Solymoss S, van Nguyen P, Demers C, Kahn SR, Kassis J, Rodger M, Hambleton J, Gent M, Ginsberg JS We sought to determine if thrombophilic defects increase recurrent VTE during Warfarin therapy. 661 patients with unprovoked VTE who were randomized to extended low-intensity (INR of 1.5-1.9) or conventional-intensity (INR 2.0-3.0) anticoagulant therapy were tested for thrombophilia and followed for a mean of 2.3 years. One or more thrombophilic defects were present in 42% of patients. The overall rate of recurrent VTE was 0.9% per patient-year. Recurrent VTE was not increased in the presence of factor V Leiden (hazard ratio [HR] 0.7; 95%CI 0.2 to 2.6); the G20210A prothrombin gene mutation (HR 0); antithrombin deficiency (HR 0); elevated factor VIII (HR 0.7; 95%CI 0.1 to 5.4); elevated factor XI (HR 0.7; 95%CI 0.1 to 5.0) or elevated homocysteine (HR 0.7; 95%CI 0.1 to 5.3); but showed a trend to an increase with an antiphospholipid antibody (HR 2.9; 95%CI 0.8 to 10.5). Compared to patients with no thrombophilic defects, the rate of recurrence was not increased in the presence of one (HR 0.7; 95%CI 0.2 to 2.3) or more than one (HR 0.7; 95%CI 0.2 to 3.4) d ...

Source: www.healthboards.com --- 24 days ago
My name is Gary, am 45 years old, very athletic, and developed blood clots on both lungs over 2 years ago. I have been taking Warfarin ever since and I'm wanting to get off. I have had no health problems since and was told that 60% of the first time ...

Source: www.nhs.uk --- 11 days ago
“People who regularly take the blood-thinning drug Warfarin may be increasing the risk of a fatal brain haemorrhage”, The Daily Telegraph reported. It said the drug is taken by many patients at risk from ischemic stroke to prevent blood clots from developing. However, a study has found that people who had a stroke and were taking the drug experienced twice as much bleeding. This in turn could cause a brain haemorrhage and death unless treated quickly. This particular risk of Warfarin has already been identified, and the aim of this study was to examine some of the details behind this risk. The benefits of Warfarin are well known, but as with all drugs, there are some risks. This study itself did not measure up these benefits and risks (for example, how many ischaemic strokes the drug prevented), but instead looks at how Warfarin might affect one aspect of brain haemorrhage. As the lead researcher is reported as saying, this study “shows the importance of good monitoring and adjustment of Warfarin dose. People should talk to their doctors about the proper management of Warfarin and learn the signs of stroke so they can get to an emergency room immediately if a stroke occurs”. Where did the story come from? Dr Matthew L. Flaherty and colleagues from the University of Cincinnati carried out this research. The study was funded in part by the National Institute of Neurological Disorder and Stroke and a University of Cincinnati College ...

Source: www.medpagetoday.com --- 12 days ago
CINCINNATI (MedPage Today) -- In patients who had an intracerebral hemorrhage, those who were taking Warfarin (Coumadin) that was not well titrated had larger hematomas and increased mortality, a retrospective analysis showed. ...

Source: hoinews.com --- 38 days ago
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Source: www.doctorslounge.com --- 31 days ago
Intracranial stenosis is caused by atherosclerosis - fatty deposits that build up on the inner walls of the arteries and restrict blood flow. ...

Source: www.theheart.org --- 1 day ago
Documentation of the care of patients in a nationwide health plan suggests that less than half of patients with atrial fibrillation are prescribed an anticoagulant. (Walker AM, Bennett D. Heart Rhythm 2008;5:1365-1372.) ...

Source: www.healthjockey.com --- 9 days ago
A new study makes a shocking revelation- the blood thinning drug Warfarin may actually be increasing your vulnerability of brain haemorrhage. The study goes on to reveal that people who are on the drug may be doing more harm than good to themselves. Warfarin is a drug administered to patients who are at risk of blood [...] ...

Source: www.newsinferno.com --- 10 days ago
A new study being published in the September 30, 2008, print issue of Neurology, the medical journal of the American Academy of Neurology, states that patients taking the popular blood thinner Warfarin may have larger amounts of bleeding in the brain and experience an increased risk of death if they suffer a hemorrhagic stroke. Warfarin [...] ...

Source: dallas.injuryboard.com --- 10 days ago
A study published in the September issue of Neurology reveals that patients who have been taking Warfarin may have suffered large amounts of bleeding in the brain and an increased risk of death if they suffer from a hemorrhagic stroke. Warfarin is usually prescribed to prevent the clotting of blood. Studies show that Warfarin aids in preventing stroke for patients with an abnormal heart rhythm, however, Warfarin is shown to over-thin blood and there is an increased risk of hemorrhage when taking it. It’s been reported that Warfarin’s side effects send more elderly patients to the emergency room every day than any other medications. The reason for this is believed to be that the correct dosages for Warfarin are very difficult to determine. Other brand names for Warfarin include Coumadin, Jantoven, Marevan and Waran. It is usually administered orally, but may sometimes be injected. It is used to stop blood clots and embolisms and most often given to people who have a history of stroke and heart attacks. Hemorrhage is a very common side effect of Warfarin. In 2004 and 2005, around 58,000 senior citizens visited the ER due to Warfarin complications. Originally posted at InjuryBoard by Jeff Rasansky ...