The oral anticoagulants warfarin sodium, acenocoumarol and phenindione, antagonise the effects of vitamin K, and take at least 48 to 72 hours for the anticoagulant effect to develop fully; warfarin sodium is the drug of choice. If an immediate effect is required, unfractionated or low molecular weight heparin must be given concomitantly.
Patients with APS and first unprovoked venous thrombosis should receive long-term treatment with vitamin K antagonists (VKA) with a target international normalised ratio (INR) of 2-3. In patients with APS with first arterial thrombosis, treatment with VKA with INR 2-3 or INR 3-4 is recommended, considering the individual's bleeding/thrombosis risk.
O Vankomycin läkemedelskoncentrationer etc. 3.4.7. Karolinska metaboliter 3.4.5. O Annan önskad analys (ange av PK-INR.
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Prothrombin Time with INR - Screening test for abnormalities of coagulation factors that are involved in the extrinsic pathway. Also used to monitor effects of Warfarin therapy and to study patients with hereditary and acquired clotting disorders.
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INR 2.0–2.3: INR 1.8–1.9: no dosage adjustment may be necessary if the last two INRs were in range, if there is no clear explanation for the INR to be out of range, and if in the judgment of the clinician, the INR does not represent an increased risk of thromboembolism for the patient
INR 3.1 - 3.4 Maintain dosage but re-check after 3 – 7 days; Consider decreasing dose by 5 - 10% and/or holding one dose. INR 3.5 - 3.9 Consider holding one dose; OR consider decreasing the maintenance dose by 5 -15% depending on magnitude of the INR elevation; Re-dosage after 1 – 3 days. INR 4.0 - 4.9 with no significant bleeding
The International Normalized Ratio, or INR, gauges the effectiveness of blood thinning medication such as warfarin.
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INR above 8.0. Asymptomatic patients with an INR above 8.0 should have their warfarin dose omitted and be given 1mg of phytomenadione orally.
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1.3. 1.3. 1.2. 1.1. Alkaline phosphatase.