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40
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Text
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URL Address
<a href="http://doi.org/10.1097/00000441-200009000-00015" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/00000441-200009000-00015</a>
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Pages
214-218
Issue
3
Volume
320
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Dublin Core
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Title
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Subtherapeutic International Normalized Ratio Despite Increasing Doses Of Warfarin: Could This Be Malabsorption?
Publisher
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American Journal of the Medical Sciences
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
2000-09
Subject
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azathioprine; drug-interaction; General & Internal Medicine; patient; resistance; therapy; warfarin malabsorption; warfarin resistance
Creator
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Lara L F; Delgado L L; Frazee L A; Haupt K M; Rutecki G W
Description
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Objective: To describe a case of warfarin resistance apparently caused by malabsorption and to review the literature regarding warfarin resistance. Case Summary: A 28-year-old renal transplant patient with systemic lupus erythematosus was admitted for upper extremity thrombophlebitis. Resistance to oral warfarin was demonstrated. Potential causes were investigated. The trapezoidal rule was used to compare the area under the curve for intravenous versus oral dosing of warfarin. The usual bioavailability of warfarin should be 100%. in this patient, warfarin bioavailability after oral dosing was 1.5%. Three potential causes, malabsorption (FF), enzymatic degradation (FC), and first-pass extraction in the portal circulation (FH), are discussed. Conclusion: This case demonstrates resistance to warfarin presumably caused by malabsorption.
Identifier
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<a href="http://doi.org/10.1097/00000441-200009000-00015" target="_blank" rel="noreferrer noopener">10.1097/00000441-200009000-00015</a>
Format
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Journal Article or Conference Abstract Publication
2000
American Journal of the Medical Sciences
azathioprine
Delgado L L
Department of Family & Community Medicine
Department of Internal Medicine
drug-interaction
Frazee L A
General & Internal Medicine
Haupt K M
Journal Article or Conference Abstract Publication
Lara L F
NEOMED College of Medicine
Patient
resistance
Rutecki G W
therapy
warfarin malabsorption
warfarin resistance