Thursday, October 18, 2018

Warfarin overdose

Q: All of the following are useful in Warfarin overdose except?

A) PCC (Prothrombin complex concentrates)  (3- or 4-factor) 

B) Fresh Frozen Plasma (FFP)
C) Vitamin K
D) Hemodialysis (HD)
E) Cholestyramine


Answer: D
  
There are two objectives for this question. First is to emphasize that HD has no role in warfarin toxicity.  Second, Cholestyramine may have some role in enhancing the elimination of warfarin in early period from the gastrointestinal(GI) tract.

All other are well know treatments of warfarin overdose.



#Toxicology



References;

Jähnchen E, Meinertz T, Gilfrich HJ, et al. Enhanced elimination of warfarin during treatment with cholestyramine. Br J Clin Pharmacol 1978; 5:437. 


Renowden S, Westmoreland D, White JP, Routledge PA. Oral cholestyramine increases elimination of warfarin after overdose. Br Med J (Clin Res Ed) 1985; 291:513.

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