Warfarin: slow-acting and long-lasting vitamin K antagonist, the only one available in the country, with onset of action 36 to 72 hours after dosing and effects lasting 3 to 5 days. The starting dose varies according to individual sensitivities: in the elderly over 70 years of age, weighing less than 50 kilograms, hepatic and renal insufficiency, and hepatic damage due to right heart failure, the dose is reduced by 25% to 50%. Monitoring of INR is usually started 24 to 72 hours after administration, and the dose is adjusted by one-fourth or one-half tablet each time until the INR reaches the desired target value. SUN Zongquan, Department of Cardiothoracic Surgery, Wuhan Union Medical College Hospital CONTRAINDICATIONS: Pregnancy, lactation, hypersensitivity, bleeding tendency or lesions with bleeding potential: recent gastroduodenal ulcers, malignant hypertension, fluid pericarditis, recent history of neurosurgical or ophthalmologic surgery, recent cerebrovascular accidents (other than cerebral infarction), severe hepatic or renal insufficiency, and in combination with some drugs. ADVERSE REACTIONS: Risk of bleeding in case of overdose or in the case of diseases with their own risk of bleeding (e.g., risk of bleeding is high with an INR greater than 5, and should not normally exceed 4.5. Gastroparesis, nausea, vomiting, diarrhea, rash, alopecia, mouth ulcers. OVERDOSAGE: Discontinue 1 to 3 doses, followed by half dose when INR returns to target range (e.g., INR greater than 9, vitamin K or plasminogen complex administered orally or intravenously, but there is a risk of thrombosis with this type of therapy). Precautions for use: Blood tests, liver and renal function, coagulation series, C-protein, prior to use; in the elderly > 70 years of age, weighing less than 50 kg, hepatic and renal insufficiency, hepatic impairment due to right-sided heart failure, hypertension, history of ulcerative disease, consultation with a specialist when dental or surgical procedures are required. Depending on the vitamin K antagonist chosen, monitoring of the INR is usually started 24 to 72 hours after administration, then every 2 days until 2 consecutive measurements are in the therapeutic target range, then once a week for half a month, then once a month, Therapeutic target: INR: 2 to 3, which is appropriate for most diseases requiring anticoagulation: thromboembolic disease, acute phase of infarction, atrial fibrillation, valvular disease, cardiac bioprosthesis. valve disease, cardiac bioprosthesis. INR: 3 to 4.5, less frequently used, e.g., recurrent systemic thromboembolism, metal heart valves, long-term treatment of infarction with complications. Heparin is often used in the introductory phase until the INR reaches the target minimum. Tapering is required for discontinuation (2 to 4 weeks) Indications for use: prophylaxis of thromboembolic disorders (3 months for first lower extremity venous thrombosis, 6 months for pulmonary embolism, and 12 months for recurrence of the first lower extremity venous thrombosis, if recurrent and long term) Mechanical valves (for life), bioprosthetic valves (greater than or equal to 3 months), valvulopathy, atrial fibrillation, postinfarction with heart failure. , post-infarction complication of heart failure or arrhythmia or ventricular wall tumor, recurrent thromboembolism of systemic systems Vitamin K antagonists and some drug and food interactions Combination of contraindications: intramuscular, intravascular, and intra-articular injections: can cause hematomas and joint pooling of blood. PYRAZOLE AINS (BOTEZONE, BENZOZONE, BUTADONE, 4-BUTYL-1,2-DIPHENYL-3,5-PYRAZOLANE), HIGH-DOSE ASPIRIN AND SALICYLIC ACID, MICCONAZOLE (DICHLOROBENZOZOLE, DICHLOROBENZOZOLE NITRATE, BISCHLOROBENZOZOLE, DARKNINE, CLOTHMENTHALIN, MECCONAZOLE, MICROCONAZOLE, MICROCONAZOLE, MYCLOZOZO, MICROCOGUINES): may cause severe hemorrhages, especially when used in conjunction with MICCONAZOLE. Hypericum perforatum houseplants commonly used in the treatment of depression and neuralgia, etc.: may reduce the efficacy of vitamin K antagonists. Unrecommended drug combinations: AINS, low-dose aspirin, diflunisic acid (diflunisic acid, diflubenzosalicylic acid, diflunisalic acid, diflunisalic acid, m-flubenzosalicylic acid, flubenzosalicylic acid), chloramphenicol, Latazepam (disodium hydroxycarboxyoxamide mycobacterium, cef hydroxycarboxyxylate,thimerosal for injection, latamoside, laxacinum cephalosporins, oxacillin disodium, hydroxycarboxyxylate mycobacterium, thimerosal, thiomarin, thiomasalazine. (Morin, Thimerosal), Fencloride: these drugs increase the risk of bleeding and therefore the dose of vitamin K antagonists should be reduced and coagulation monitoring should be improved (the risk of bleeding may be increased 3 to 5 times when vitamin K antagonists are used in combination with low-dose aspirin when INR values of 2 to 3 are the control goal). Caution should be exercised when combining the following drugs: