Drug effects
1. Drugs that enhance the anticoagulant effect are as follows.
Make the intestine produce less vitamin K: broad-spectrum antibacterial agents.
Compete for plasma protein binding sites, so that the proportion of drugs bound to protein at the end increases: aspirin, Antomin, sulforaphane, propofol. Sun Zongquan, Department of Cardiac Surgery, Wuhan Union Medical College Hospital
Decrease the absorption of vitamin K: liquid paraffin, etc.
Inhibits enzymes that degrade warfarin: chloramphenicol, metronidazole, meclizine, disulfiram, alcohol.
Compete for the same surrogate route of injection: phenytoinamide, toluenosulfonylurea.
Enhancing their action or altering other coagulants at the site of drug administration: quinidine, antamine, methacholine, phenylephrine.
Synergistic anticoagulant effects: aspirin, acetaminophen.
Affect platelet function: salicylates, pautazone, chlorpromazine, phenylephrine.
2. The drugs that reduce the anticoagulant effect are as follows.
The intestinal tract and anticoagulant drugs conjunctive whole: abciximide.
Promote hepatic microsomal enzyme activity, accelerate the intrahepatic metabolism of warfarin: hypnotics, rifampin, ashwagandha.
Increase the level of blood juxtaposition factors: estrogens, oral contraceptives.
Effect of food
Foods rich in vitamin K can reduce the effect of the drug, the amount of vitamin K per 100 g of dry food (mg): spinach (4.40), cabbage (3.20), cauliflower (3.00), peas (2.80), carrots (0.80), tomatoes (0.40 – 0.80), potatoes (0.16), pig liver (0.80), eggs (0.80), cow’s milk ( trace). Long-term consumption of large quantities of the above-mentioned foods should be promptly tested to adjust the dosage of farin.
Effect of disease
Diarrhea and vomiting can affect the absorption of the drug. Liver stasis and liver disease in heart failure can reduce the synthesis of vitamin K, which can reduce the dosage of warfarin.
Influence of warfarin drug itself
Pay attention to the expiration date of the drug, the dose of each tablet (there are 2.5mg, 3mg, 5mg and other dosage forms).
The drug has no dampness, mold, deterioration.
Time of blood collection
Whether the peak time is reached after taking the drug (after taking the drug).
Assay error
There is an error in the test, if necessary, repeat the blood collection test, or draw normal human blood for control at the same time. If there is a change in the test result, you should think of the above factors, and conversely, when applying drugs or changing the type of diet, you should also think of the effect of anticoagulation, and consult your doctor in a timely manner.