A patient of thromobosis of hepatic veins has been receiving coumarin therapy for a duration of three years. Recently, she has developed bleeding tendency. How will you reverse the effect of coumarin?
Correct Answer: Vit K injection
Description: Ans. is 'b' i.e. Vitamin K injection Bleeding is the commonest complication of warfarin therapyThe anticoagulant actions of warfarin occurs due to antagonism of Vitamin K, so quiet obviously, vitamin K is used for reversal of anticoagulant action of warfarin.Three forms of vitamin K are available for therapeutic use i.e.PhytonadioneMenaquinoneMenadioneTo reverse the effect of overdose of oral anticoagulants, phytonadione is the preparation of choice because it acts most rapidly.Dose depends upon the severity of hypoprothrombinemia (measured INR) and bleeding.Unnecessary high dose is to be avoided because it will render the patient unresponsive to oral anticoagulants for several days.Management of bleeding due to over anticoagulationManagement of bleeding due to over anticoagulation is guided by the clinical state and the prothrombin time (it is expressed as International normalised ratio (INR), which is the ratio of prothrombin time in the patient to that in a normal (non anticoagulated person)INR 2.0-4.5-It is the normal therapeutic range.INR 4.5-7.0 Managed by withholding warfarin for 1-2 days and then reviewing the INRINR > 7 but without Corrected by withholding warfarin and giving phytomenadione .5 mg by slowbleeding i.v. injection if judged appropriateBleeding threatening life-* Blood replacementor major organs * Reversal of anticoagulationFor rapid reversal - prothrombin complex concentrate For full reversal - phytomenadione i.v.
Category:
Pharmacology
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now