![]() Vitamin K is available as a 10mg/ml solution. Oral vitamin K dose: The injection solution can be given orally (the 10mg tablet is not readily divided into smaller doses). The following chart compares oral anticoagulant indications, clinical benefit, antidotes, washout, switching to/from warfarin, and other therapeutic considerations. this traditional antidote is ineffective for reversing the effect of either. Comparison of Oral Anticoagulants The proliferation of oral anticoagulants has healthcare professionals questioning how to choose among them. The current IV vitamin K preparation can be given as an IV push over 2-3 mins.Įffects of INR from IV vitamin K seen within 4 hours, for oral vitamin K 12-24 hours. However, the INR does not give an accurate evaluation of coagulation status. If the INR falls significantly below the therapeutic range additional anticoagulant therapy should be considered for patients with a high risk of thrombosis. In January 1985, the United States (US) Food and Drug Administration (FDA) approved the oral administration of acetylcysteine (N-acetylcys-teine, NAC) as an antidote for the treatment of acetaminophen overdose. This protocol gives relatively aggressive reversal of warfarin. Patient with an INR above the therapeutic range with a high risk of bleedingĦ-12 hours early testing may be necessary if INR excessively above 9 or risk of bleeding assessed as very high. May offer advantage over FFP as a small volume and there is no time delay in thawing. The INR can be measured within 15mins of dose completion and doses repeated as necessary depending on the INR. WarfarinĢ5-50 IU/kg Octaplex plus 2 units of FFP if Octaplex not readily available 4 units FFP.Īssess patient continuously until both INR 5.0 use a dose closer to 50IU/kg.Īdminister at a rate of 3ml/min or as tolerated by the patient. It is for any clinically significant bleeding where warfarin induced coagulopathy is considered a contributing factor. This intervention is designed to rapidly reverse the INR in what may be life-threatening circumstances. Patient has clinically significant bleeding Today's video is all about anti-coagulants heparin vs warfarin for Nursing Students and NCLEX Review.For your FREE quiz and access to more. ![]() There is a smart phone app available to assist with managing over dose. If a patient has a high INR consider the following possible causesĪn elevated INR can significantly increase the risk of death from haemorrhage Smart Phone app Treatment strategy for warfarin over-anticoagulation
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