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Individual dosage of warfarin

作者:Hua Luo   发布时间:2012-09-18 08:37:12   浏览次数:671
The study of individual dosage of warfarin and its application in pulmonary thromboembolism  
LUO Hua ICU of Peking university Shenzhen HospitalShenzhen 518036China), LIANG Ying ,YANG Jinghua et al Department of Pulmonary Medicine, Beijing anzhen Hospital, Affiliated Hospital of Capital University of Medical Science, Beijing China 100029
 
  [Abstract] Objective: To determine the best suitable maintenance dose of warfarin and normalize warfarin application in pulmonary thromboembolism (PTE) that can make international normalized ratio (INR) achieve therapeutic range (2 to 3 times the control) promptly. Methods: From the data of ninety-four patients with PTE who received warfarin therapy, the average dosage each day of patients with INR of 2 to 3 were calculated; On day 3, day 5 and day 10 after warfarin therapy, groups that initiated dose from 3-mg and 6-mg  were compared. Result: Fifty-six of ninety-four patients with PTE achieved INR therapeutic range steadily, occupying 59.6% of all. In which, the average dosage of warfarin of each individual per day was 4.097 mg. 25 patients in group 3-mg and 22 patients in group 6-mg achieved INR of 2 to 3 after warfarin therapy , the number and percent of patients with INR of  2 to 3 in group 6-mg was greater than patients in group 3-mg on day 3, day 5 and day 10 respectivelyP<0.05. Both groups had same warfarin requirement, 29 mg in average, before achieving INR therapeutic range. The day to achieve INR of 2 to 3 averaged 5~6 in group 6-mg and 8~9 in group 3-mg respectivelyP<0.05. There was a inverse relationship between age and warfarin requirement. All of patients had no bleeding incident during warfarin therapy, one of thirty-four had recurrent thromboembolism in group 6-mg. Conclusion: In early 5~6 days of therapy, a loading dose in initiation of warfarin therapy can achieve INR of 2 to 3 rapidly, without excess bleeding, and avoid the development of a potential hypercoagulable state. The maintenance dose of warfarin averaged 4-mg per day.
 [Key words] Pulmonary thromboembolism   Warfarin      Anticoagulation therapy






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