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Intravenous warfarin as an alternative for anticoagulation
1Pharmacy Department, Royal Columbian Hospital, Fraser Health Authority, New Westminster, British Columbia, Canada. Rochelle.Gellatly@fraserhealth.ca
Pharmacotherapy
|June 5, 2007
Summary
For patients with Crohn's disease resistant to oral warfarin, intravenous warfarin offers a viable anticoagulation alternative. This method ensures therapeutic levels when oral absorption is compromised or other anticoagulants are contraindicated.
Area of Science:
- Gastroenterology
- Hematology
- Pharmacology
Background:
- Oral warfarin is the standard for long-term anticoagulation in venous thromboembolic disease.
- Crohn's disease can impair oral medication absorption due to gastrointestinal damage and inflammation.
Observation:
- A patient with end-stage Crohn's disease experienced upper extremity thrombosis.
- This patient exhibited resistance to oral warfarin and could not tolerate low-molecular-weight heparin.
- Therapeutic anticoagulation was successfully achieved using intravenous warfarin.
Findings:
- Intravenous warfarin administration bypasses potential malabsorption issues associated with Crohn's disease.
- This route provides an effective anticoagulation strategy for complex cases.
Implications:
- Intravenous warfarin is a crucial alternative for anticoagulation in patients with compromised oral absorption.
- It expands treatment options for patients with venous thromboembolic disease and inflammatory bowel disease.
- This approach may improve outcomes in challenging anticoagulation scenarios.
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