Warfarin Overdose in an Adolescent Not Dependent on Anticoagulation: Reversal Strategy and Kinetics.
Drug overdose
Phytonadione
Toxicokinetics
Warfarin
Journal
Journal of medical toxicology : official journal of the American College of Medical Toxicology
ISSN: 1937-6995
Titre abrégé: J Med Toxicol
Pays: United States
ID NLM: 101284598
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
received:
19
04
2022
accepted:
21
07
2022
revised:
13
07
2022
pubmed:
7
9
2022
medline:
24
9
2022
entrez:
6
9
2022
Statut:
ppublish
Résumé
Warfarin induces coagulopathy. Guidelines protocolize reversal of supratherapeutic international normalized ratio (INR) in patients dependent on anticoagulation, but practices vary for reversing warfarin-induced coagulopathy after overdose in non-warfarin-dependent patients. This is the report of a 15-year-old female who ingested her father's warfarin (100-200 mg) in a self-harm attempt. At hour 24 post-ingestion, her INR was 2.00 and she was admitted for monitoring. Reversal of coagulopathy was initially deferred pending the INR trend. The INR was 5.10 at hour 60 and 2.5 mg oral vitamin K A restrictive approach to coagulopathy reversal in non-warfarin-dependent patients with intentional warfarin overdose may result in worsening coagulopathy, bleeding, and lengthy hospital stay. Given the risk for significant, prolonged coagulopathy, these patients should be treated early with VK1, with subsequent serial INR monitoring and probable additional VK1 dosing. Delayed peak warfarin concentrations support consideration of gastrointestinal decontamination in late presenters.
Identifiants
pubmed: 36066724
doi: 10.1007/s13181-022-00907-1
pii: 10.1007/s13181-022-00907-1
pmc: PMC9492822
doi:
Substances chimiques
Anticoagulants
0
Vitamin K
12001-79-5
Warfarin
5Q7ZVV76EI
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
334-339Informations de copyright
© 2022. American College of Medical Toxicology.
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