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Attempted Suicide by Massive Warfarin Ingestion Conservatively Managed Using Phytonadione
Katherine L March1, Kruti S Patel2, Jennifer D Twilla1
1Methodist University Hospital, 1265 Union Ave., Memphis, TN 38104, USA; Department of Clinical Pharmacy, University of Tennessee Health Science Center, 881 Madison Ave., Memphis, TN 38163, USA.
Case Reports in Hematology
|January 4, 2017
Summary
This case study highlights effective warfarin toxicity management. Phytonadione (vitamin K1) alone successfully treated massive warfarin overdose, avoiding risks associated with fresh frozen plasma and prothrombin complex concentrates.
Area of Science:
- Pharmacology
- Toxicology
- Internal Medicine
Background:
- Warfarin is a critical oral anticoagulant for thromboembolic disease.
- Massive warfarin ingestion can lead to life-threatening hemorrhages.
- Established treatment guidelines for acute warfarin toxicity are limited.
Purpose of the Study:
- To describe a case of massive warfarin overdose.
- To evaluate treatment strategies for acute warfarin toxicity.
- To assess the efficacy of phytonadione (vitamin K1) in managing warfarin overdose.
Main Methods:
- A case report of a 63-year-old female with massive warfarin ingestion (420-450 mg).
- Serial International Normalized Ratio (INR) monitoring to guide treatment.
- Treatment solely with phytonadione (vitamin K1), with dosage adjusted based on INR response.
Main Results:
- Phytonadione monotherapy was effective in reversing anticoagulation.
- INR levels were successfully managed and normalized.
- Avoided potential complications associated with fresh frozen plasma and prothrombin complex concentrates.
Conclusions:
- Phytonadione (vitamin K1) monotherapy can be a safe and effective treatment for massive warfarin overdose.
- This approach may mitigate risks and costs associated with alternative treatments.
- Further research is warranted to establish definitive treatment protocols.
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