Malabsorption-associated warfarin resistance
Title
Malabsorption-associated warfarin resistance
Creator
Sabol B J; Basa R R; Wilkins C E
Publisher
American Journal of Health-System Pharmacy
Date
2009
2009-09
Description
Purpose. A case of malabsorption-associated warfarin resistance is reported. Summary. A 42-year-old, 111-kg, Caucasian man arrived at the emergency department with atypical pleuritic chest pain. The chest pain was associated with shortness of breath, diaphoresis, nausea, vomiting, and tachycardia. The patient's medical history was significant for multiple episodes of deep venous thrombosis (DVT) in the left upper extremity and both lower extremities, a right above-the-knee amputation due to complications of a previous DVT, insertion of a vena cava filter, pulmonary embolism (PE), asthma, hypertension, and multiple myocardial infarctions. During admission, he was diagnosed presumptively with PE. All potential causes of interference with warfarin absorption were investigated and ruled out. IN. warfarin therapy at a conventional initial dosage of 5 mg once daily was started on hospital day 2. The International Normalized Ratio (INR) reached the therapeutic range after increasing the i.v. warfarin dosage to 7.5 mg once daily on hospital day 6. The ability to obtain a therapeutic INR on a relatively low dosage of i.v. warfarin but not high dosages of oral warfarin strongly suggests an inherent warfarin malabsorption defect in this patient. Conclusion. A 42-year-old man with a history of recurrent thromboembolisms demonstrated resistance to oral warfarin therapy due to warfarin malabsorption.
Subject
5-mg; absorption; absorption; Albuterol; Anticoagulants; Aspirin; Atorvastatin calcium; coumarin anticoagulant drugs; Diazepam; Dosage; Fluticasone; genotype; hereditary; International normalized ratio; Metoprolol tartrate; patient; pharmacodynamics; Pharmacology & Pharmacy; resistance; risk; Salmeterol; short-bowel syndrome; Venous thrombosis; Warfarin sodium
Identifier
Format
Journal Article
URL Address
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Rights
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Pages
1548-1553
Issue
17
Volume
66
Citation
Sabol B J; Basa R R; Wilkins C E, “Malabsorption-associated warfarin resistance,” NEOMED Bibliography Database, accessed April 25, 2024, https://neomed.omeka.net/items/show/6985.