[Diagnosis and treatment of warfarin resistance].

Abstract

Warfarin resistance is a phenomenon that patients need to take much higher than normally prescribed dosage of warfarin to maintain the target therapeutic international normalized ratio (INR) range, or even fail to reach the target INR. Warfarin resistance can be categorized in etiologic terms as hereditary vs acquired, or in pharmacologic terms as pharmacokinetic vs pharmacodynamic. Once warfarin resistance is diagnosed, the type of resistance should be determined as soon as possible so that treatment could be oriented toward the causes. Poor compliance, genetic mutations, concurrent medications that could decrease the absorption or increase the clearance of warfarin, and consumption of diet rich in vitamin K are the major reasons for warfarin resistance. Educating patients, increasing warfarin dosage and switching to other anticoagulants would be effective for warfarin resistance.

• Authors: Shenglan Tan, Xinmin Zhou, Zhi Li, Wei Zhang, Zhaoqian Liu, Honghao Zhou
• Journal: Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences (Zhong Nan Da Xue Xue Bao Yi Xue Ban) Vol. 38 Issue 3 Pg. 313-7 (Mar 2013) ISSN: 1672-7347 [Print] China
• PMID: 23545828 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Anticoagulants
• Vitamin K
• VKORC1 protein, human
• Vitamin K Epoxide Reductases

Topics

• Anticoagulants (pharmacology)
• Drug Monitoring (methods)
• Female
• Humans
• International Normalized Ratio
• Male
• Metabolism, Inborn Errors (diagnosis, etiology, genetics)
• Vitamin K (administration & dosage)
• Vitamin K Epoxide Reductases (genetics)