A. How to take warfarin
1.After heart valve mechanical valve replacement surgery must be anticoagulation therapy. Warfarin is the anticoagulant of choice. Take it for life.
2.Take it regularly: 8:00 every night is recommended
3.Cautions.
(1) Occasionally forget to take it, the next day may not take the previous day’s medicine together. Li Xuewen, Cardiovascular Surgery Department, Shaanxi Provincial People’s Hospital
(2) Please try to take the same pharmaceutical company products, if there is a change, remember that the dose is the same rather than the number of tablets consistent.
(3) Please be careful to keep enough medicine in reserve for at least one month to avoid delays when you run out of medicine and cannot buy it.
(4) Please be careful to avoid taking food at the same time.
(5) Please tell the doctor that you are taking warfarin and present the discharge summary issued by our department to ask the doctor to make relevant preparations before performing any invasive examinations and procedures in the future.
(6) Sudden bleeding after no bleeding from brushing your teeth on a regular basis.
Women’s menstruation is significantly more or longer than usual
Large petechiae appearing after a slight collision
Sudden inability to move the extremities
Appearance of hematuria or bloody stool
All the above situations indicate taking too much or too little medication, please contact your doctor immediately.
Second, how to check the prothrombin time (blood PT)
1.The purpose is to adjust the amount of warfarin taken to prevent overdose – risk of bleeding, underdose – risk of thrombosis.
2.Regular check
1-2 months after discharge from hospital —- check every week
March-June —- checked every two weeks
July-December —- every one month
After one year —- once every two to three months
3. Determination of examination results: If the examination items of your hospital have International Normalized Ratio (INR), then according to
The following criteria are adjusted (25% of the extended normal value)
INR greater than 1.7 less than 2.3 Warfarin dosage remains unchanged
INR less than 1.7 Warfarin dosage increased by 0.625 mg (1/4 tablet)
INR greater than 2.3 Warfarin dosage reduced by 0.625 mg (1/4 tablet)
If INR is not available, adjust based on blood PT (prothrombin time) by the following criteria (25% extension of normal value)
PT greater than 16 seconds less than 20 seconds No change in warfarin dosage
PT less than 16 seconds Warfarin dosage increased by 0.625 mg (1/4 tablet)
PT greater than 20 seconds Warfarin dosage reduced by 0.625 mg (1/4 tablet)
Special circumstances: If INR is greater than 3.0 or blood PT is greater than 30 seconds, which is likely to cause bleeding, please stop taking warfarin on the same day and start to reduce the dosage on the next day. At the same time, please contact your doctor immediately, present your checklist and the discharge summary from our department, and ask him/her to give you an intramuscular injection of VitK1 (Vitamin K1) 20 mg. The blood PT will be retested the next day for adjustment. (The above results are for reference only)
Six months after discharge from the hospital, we recommend that you come to our hospital for a follow-up cardiac ultrasound. If you have any questions and discomfort, please contact our department.
Shaanxi Provincial People’s Hospital Cardiovascular Surgery Center Consultation Phone Number: 029-85253261 ext. 3099, 2509 Ask for the doctor on duty or the doctor in charge during your hospitalization.