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Current Concepts of Warfarin Therapy

Current Concepts of Warfarin Therapy Abstract • Oral anticoagulants are used extensively, although their risks are not always fully recognized. The prophylaxis of venous thrombosis after hip surgery, the prevention of deep venous thrombosis and pulmonary emboli after an acute episode of these, the prevention of arterial emboli from the heart in patients at risk, and the prophylaxis of thrombosis in patients with congenital deficiency of antithrombin III, protein C, or protein S are some of the indications for oral anticoagulant use. Warfarin sodium is contraindicated in pregnancy, however. The recommended prothrombin time is 1½ to two times control, lower than previously. The major risk of oral anticoagulant therapy, bleeding, is treated with vitamin K or plasma, depending on its severity. Warfarin necrosis and the "purple-toe" syndrome are seen more frequently than realized. (Arch Intern Med 1986;146:581-584) References 1. Stenflo J: Vitamin K, prothrombin and gamma-carboxyglutamic acid. N Engl J Med 1977;296:624-626.Crossref 2. Koch-Weser J, Sellers EM: Drug interactions with coumarin anticoagulants. N Engl J Med 1971;285:487-498, 547-558.Crossref 3. Williams JRB, Griffin JP, Parkins A: Effect of concomitantly administered drugs on the control of long-term anticoagulant therapy. Q J Med 1976;177:63-73. 4. McElnay JC, Harron DWG, D'Arcay PF, et al: The interaction of warfarin with antacid constituents in the gut. Experientia 1979;35:1359-1360.Crossref 5. Watson PG, Lochan RG, Redding VJ: Drug interaction with coumarin derivative anticoagulants. Br Med J 1982;285:1045-1046.Crossref 6. Qureshi GD, Reinders TP, Swint JJ, et al: Acquired warfarin resistance and weight-reducing diet. Arch Intern Med 1981;141:507-509.Crossref 7. Corrigan JJ Jr: The effect of vitamin E on warfarin induced vitamin K deficiency. Ann NY Acad Sci 1982;393:361-368.Crossref 8. Goulbourne IA, Macleod DAD: An interaction between danazol and warfarin: Case report. Br J Obstet Gynaecol 1981;88:950-951.Crossref 9. Udall JA: Clinical complications of warfarin interactions with five sedatives. Am J Cardiol 1975;35:67-72.Crossref 10. Romankiewicz JA, Ehrman M: Rifampin and warfarin: A drug reaction. Ann Intern Med 1975;82:224-225.Crossref 11. Qureshi GD, Reinders TP, Somori GJ, et al: Warfarin resistance with nafcillin therapy. Ann Intern Med 1984;100:527-529.Crossref 12. Schwartz J, Bachmann K, Perrigo E: Interaction between warfarin and erythromycin. South Med J 1983;76:91-93.Crossref 13. Feely J: Interaction of cimetidine with other drugs. South Med J 1983;76:753-758.Crossref 14. O'Reilly RA: Stereoselective interaction of sulfinpyrazone with racemic warfarin and its separated enantiomorphs in man. Circulation 1982;65:202-207.Crossref 15. O'Reilly RA: Stereoselective interaction of trimethoprim-sulfameth-oxazole with the separated enantiomorphs of racemic warfarin in man. N Engl J Med 1980;302:33-35.Crossref 16. KwaanHC, Bowie EJW: Thrombosis . Philadelphia, WB Saunders Co, 1982. 17. Colman RW, Hirsh J, Marder VJ, et al: Hemostasis and Thrombosis . Philadelphia, JB Lippincott Co, 1982. 18. Sevitt S: Prevention of venous thromboembolism by oral anticoagulant therapy , in Fratantoni J, Wessler S (eds): Prophylactic Therapy of Deep Vein Thrombosis and Pulmonary Embolism , publication 76-866. Dept of Health, Education, and Welfare, National Institutes of Health, 1976, pp 143-148. 19. Francis CW, Marder VJ, Evarts CM, et al: Two-step warfarin therapy: Prevention of postoperative venous thrombosis without excessive bleeding. JAMA 1983;249:374-378.Crossref 20. Coon WW, Willis PW III: Recurrence of venous thromboembolism. Surgery 1973;73:823-827. 21. Duvoisin GE, Brandenburg RO, McGoon DC: Factors affecting thromboembolism associated with prosthetic heart valves. Circulation 1976;35( (suppl 1) ):70-76. 22. Szekely P: Systematic embolism and anticoagulant prophylaxis in rheumatic heart disease. Br Med J 1964;12:1209-1211.Crossref 23. Wilson WR, Geraci JE, Danielson GK, et al: Anticoagulant therapy and central nervous system complications in patients with prosthetic valve endocarditis. Circulation 1978;57:1004-1007.Crossref 24. Wessler S, Gitel SN: Warfarin: From bedside to bench. N Engl J Med 1984;311:645-652.Crossref 25. Steele P, Rainwater J, Vogel R: Platelet suppressant therapy in patients with prosthetic cardiac valves: Relationship of clinical effectiveness to alteration of platelet survival time. Circulation 1979;60:910-913.Crossref 26. Chesebro JH, Fuster V, Elveback LR, et al: Trial of combined warfarin plus dipyridamole or aspirin therapy in prosthetic heart valve replacement: Danger of aspirin compared with dipyridamole. Am J Cardiol 1983;51:1537-1541.Crossref 27. Fuster V, Gersh BJ, Giuliani ER, et al: The natural history of idiopathic dilated cardiomyopathy. Am J Cardiol 1981;47:525-531.Crossref 28. Hinton RC, Kistler JP, Fallon JT, et al: Influence of etiology of atrial fibrillation on incidence of systemic embolism. Am J Cardiol 1977;40:509-513.Crossref 29. Ebert RV, Beard OW, Schnaper HW, et al: Anticoagulants in acute myocardial infarction: Results of a cooperative trial. JAMA 1973;225:724-729.Crossref 30. Weinreich DJ, Burke JF, Pauletto FJ: Left ventricular mural thrombi complicating acute myocardial infarction. Ann Intern Med 1984;100:789-794.Crossref 31. Marciniak E, Farley CH, DeSimone PA: Familial thrombosis due to antithrombin III deficiency. Blood 1974;43:219-231. 32. Broekmans AW, Veltkamp JJ, Bertina RM: Congenital protein C deficiency and venous thromboembolism: A study of three Dutch families. N Engl J Med 1983;309:340-344.Crossref 33. Comp PC, Esmon CT: Recurrent venous thromboembolism in patients with a partial deficiency of protein S. N Engl J Med 1984;311:1525-1528.Crossref 34. Hull R, Hirsh J, Jay R, et al: Different intensities of oral anticoagulant therapy in the treatment of proximal-vein thrombosis. N Engl J Med 1982;307:1676-1681.Crossref 35. Coon WW, Willis PW III: Hemorrhagic complications of anticoagulant treatment. Arch Intern Med 1974;133:386-392.Crossref 36. Scandling J, Walker BK: Extensive tissue necrosis associated with warfarin sodium therapy. South Med J 1980;73:1470-1472.Crossref 37. McGehee WG, Klotz TA, Epstein DJ, et al: Coumarin necrosis associated with hereditary protein C deficiency. Ann Intern Med 1984;100: 59-60.Crossref 38. Akle CA, Joiner CL: Purple toe syndrome: Case reports. J R Soc Med 1981;74:219. 39. Hall JG, Pauli RM, Wilson KM: Maternal and fetal sequelae of anticoagulation during pregnancy. Am J Med 1980;68:122-140.Crossref 40. O'Reilly RA, Aggeler PM: Oral anticoagulants in man. Pharmacol Rev 1970;22:35-96. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Current Concepts of Warfarin Therapy

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References (51)

Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1986.00360150231028
Publisher site
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Abstract

Abstract • Oral anticoagulants are used extensively, although their risks are not always fully recognized. The prophylaxis of venous thrombosis after hip surgery, the prevention of deep venous thrombosis and pulmonary emboli after an acute episode of these, the prevention of arterial emboli from the heart in patients at risk, and the prophylaxis of thrombosis in patients with congenital deficiency of antithrombin III, protein C, or protein S are some of the indications for oral anticoagulant use. Warfarin sodium is contraindicated in pregnancy, however. The recommended prothrombin time is 1½ to two times control, lower than previously. The major risk of oral anticoagulant therapy, bleeding, is treated with vitamin K or plasma, depending on its severity. Warfarin necrosis and the "purple-toe" syndrome are seen more frequently than realized. (Arch Intern Med 1986;146:581-584) References 1. Stenflo J: Vitamin K, prothrombin and gamma-carboxyglutamic acid. N Engl J Med 1977;296:624-626.Crossref 2. Koch-Weser J, Sellers EM: Drug interactions with coumarin anticoagulants. N Engl J Med 1971;285:487-498, 547-558.Crossref 3. Williams JRB, Griffin JP, Parkins A: Effect of concomitantly administered drugs on the control of long-term anticoagulant therapy. Q J Med 1976;177:63-73. 4. McElnay JC, Harron DWG, D'Arcay PF, et al: The interaction of warfarin with antacid constituents in the gut. Experientia 1979;35:1359-1360.Crossref 5. Watson PG, Lochan RG, Redding VJ: Drug interaction with coumarin derivative anticoagulants. Br Med J 1982;285:1045-1046.Crossref 6. Qureshi GD, Reinders TP, Swint JJ, et al: Acquired warfarin resistance and weight-reducing diet. Arch Intern Med 1981;141:507-509.Crossref 7. Corrigan JJ Jr: The effect of vitamin E on warfarin induced vitamin K deficiency. Ann NY Acad Sci 1982;393:361-368.Crossref 8. Goulbourne IA, Macleod DAD: An interaction between danazol and warfarin: Case report. Br J Obstet Gynaecol 1981;88:950-951.Crossref 9. Udall JA: Clinical complications of warfarin interactions with five sedatives. Am J Cardiol 1975;35:67-72.Crossref 10. Romankiewicz JA, Ehrman M: Rifampin and warfarin: A drug reaction. Ann Intern Med 1975;82:224-225.Crossref 11. Qureshi GD, Reinders TP, Somori GJ, et al: Warfarin resistance with nafcillin therapy. Ann Intern Med 1984;100:527-529.Crossref 12. Schwartz J, Bachmann K, Perrigo E: Interaction between warfarin and erythromycin. South Med J 1983;76:91-93.Crossref 13. Feely J: Interaction of cimetidine with other drugs. South Med J 1983;76:753-758.Crossref 14. O'Reilly RA: Stereoselective interaction of sulfinpyrazone with racemic warfarin and its separated enantiomorphs in man. Circulation 1982;65:202-207.Crossref 15. O'Reilly RA: Stereoselective interaction of trimethoprim-sulfameth-oxazole with the separated enantiomorphs of racemic warfarin in man. N Engl J Med 1980;302:33-35.Crossref 16. KwaanHC, Bowie EJW: Thrombosis . Philadelphia, WB Saunders Co, 1982. 17. Colman RW, Hirsh J, Marder VJ, et al: Hemostasis and Thrombosis . Philadelphia, JB Lippincott Co, 1982. 18. Sevitt S: Prevention of venous thromboembolism by oral anticoagulant therapy , in Fratantoni J, Wessler S (eds): Prophylactic Therapy of Deep Vein Thrombosis and Pulmonary Embolism , publication 76-866. Dept of Health, Education, and Welfare, National Institutes of Health, 1976, pp 143-148. 19. Francis CW, Marder VJ, Evarts CM, et al: Two-step warfarin therapy: Prevention of postoperative venous thrombosis without excessive bleeding. JAMA 1983;249:374-378.Crossref 20. Coon WW, Willis PW III: Recurrence of venous thromboembolism. Surgery 1973;73:823-827. 21. Duvoisin GE, Brandenburg RO, McGoon DC: Factors affecting thromboembolism associated with prosthetic heart valves. Circulation 1976;35( (suppl 1) ):70-76. 22. Szekely P: Systematic embolism and anticoagulant prophylaxis in rheumatic heart disease. Br Med J 1964;12:1209-1211.Crossref 23. Wilson WR, Geraci JE, Danielson GK, et al: Anticoagulant therapy and central nervous system complications in patients with prosthetic valve endocarditis. Circulation 1978;57:1004-1007.Crossref 24. Wessler S, Gitel SN: Warfarin: From bedside to bench. N Engl J Med 1984;311:645-652.Crossref 25. Steele P, Rainwater J, Vogel R: Platelet suppressant therapy in patients with prosthetic cardiac valves: Relationship of clinical effectiveness to alteration of platelet survival time. Circulation 1979;60:910-913.Crossref 26. Chesebro JH, Fuster V, Elveback LR, et al: Trial of combined warfarin plus dipyridamole or aspirin therapy in prosthetic heart valve replacement: Danger of aspirin compared with dipyridamole. Am J Cardiol 1983;51:1537-1541.Crossref 27. Fuster V, Gersh BJ, Giuliani ER, et al: The natural history of idiopathic dilated cardiomyopathy. Am J Cardiol 1981;47:525-531.Crossref 28. Hinton RC, Kistler JP, Fallon JT, et al: Influence of etiology of atrial fibrillation on incidence of systemic embolism. Am J Cardiol 1977;40:509-513.Crossref 29. Ebert RV, Beard OW, Schnaper HW, et al: Anticoagulants in acute myocardial infarction: Results of a cooperative trial. JAMA 1973;225:724-729.Crossref 30. Weinreich DJ, Burke JF, Pauletto FJ: Left ventricular mural thrombi complicating acute myocardial infarction. Ann Intern Med 1984;100:789-794.Crossref 31. Marciniak E, Farley CH, DeSimone PA: Familial thrombosis due to antithrombin III deficiency. Blood 1974;43:219-231. 32. Broekmans AW, Veltkamp JJ, Bertina RM: Congenital protein C deficiency and venous thromboembolism: A study of three Dutch families. N Engl J Med 1983;309:340-344.Crossref 33. Comp PC, Esmon CT: Recurrent venous thromboembolism in patients with a partial deficiency of protein S. N Engl J Med 1984;311:1525-1528.Crossref 34. Hull R, Hirsh J, Jay R, et al: Different intensities of oral anticoagulant therapy in the treatment of proximal-vein thrombosis. N Engl J Med 1982;307:1676-1681.Crossref 35. Coon WW, Willis PW III: Hemorrhagic complications of anticoagulant treatment. Arch Intern Med 1974;133:386-392.Crossref 36. Scandling J, Walker BK: Extensive tissue necrosis associated with warfarin sodium therapy. South Med J 1980;73:1470-1472.Crossref 37. McGehee WG, Klotz TA, Epstein DJ, et al: Coumarin necrosis associated with hereditary protein C deficiency. Ann Intern Med 1984;100: 59-60.Crossref 38. Akle CA, Joiner CL: Purple toe syndrome: Case reports. J R Soc Med 1981;74:219. 39. Hall JG, Pauli RM, Wilson KM: Maternal and fetal sequelae of anticoagulation during pregnancy. Am J Med 1980;68:122-140.Crossref 40. O'Reilly RA, Aggeler PM: Oral anticoagulants in man. Pharmacol Rev 1970;22:35-96.

Journal

Archives of Internal Medicine – American Medical Association

Published: Mar 1, 1986

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