Related Experiment Video
Updated: Dec 14, 2025
11:17
Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
14.2K
Fixed-dose three-factor prothrombin complex concentrates is safe and effective in warfarin reversal
Kirsty Marshall1, Eileen Merriman1, Merit Hanna1
1Department of Haematology, Waitemata District Health Board, Auckland, New Zealand.
Internal Medicine Journal
|July 21, 2020
Summary
Fixed-dose prothrombin complex concentrates (PCC) effectively reverse warfarin, achieving target international normalised ratios (INR) in most patients. This approach is safe and comparable to weight-based dosing for warfarin reversal in clinical practice.
Area of Science:
- Pharmacology
- Clinical Medicine
- Hematology
Background:
- Warfarin reversal with prothrombin complex concentrates (PCC) is crucial for managing bleeding or urgent surgery.
- While weight-based dosing is common, fixed-dose PCC offers a feasible alternative with comparable outcomes.
Purpose of the Study:
- To audit the clinical and laboratory outcomes of fixed-dose PCC for warfarin reversal.
- To evaluate post-reversal international normalised ratio (INR) and complication rates.
- To compare outcomes between reduced-dose (≤15 IU/kg) and standard-dose (>15 IU/kg) PCC.
Main Methods:
- Retrospective analysis of 144 patients receiving three-factor PCC for warfarin reversal in 2016.
- Extraction of clinical data and PCC dosages from electronic patient records.
Main Results:
- Median pre-reversal INR of 3.25 reduced to 1.5 post-reversal; 87% achieved INR < 2.
- 16 patients required repeat PCC; 22 (15.3%) experienced complications (15 deaths, 7 thrombosis, 2 hemorrhage).
- No significant differences in outcomes between reduced-dose and standard-dose subgroups.
Conclusions:
- Fixed-dose PCC is a viable and effective strategy for warfarin reversal in routine hospital practice.
- The study supports the use of fixed-dose PCC in day-to-day clinical settings.
- Outcomes are comparable to weight-based dosing, supporting its clinical utility.
Related Concept Videos
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.8K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.8K
01:29Venous Thrombosis III: Interprofessional Care
189
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
189
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
1.4K
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
1.4K
01:26EDTA: Auxiliary Complexing Reagents
1.1K
EDTA titrations are usually carried out in highly basic conditions, where the fully deprotonated form of EDTA, Y4−, actively complexes with the free metal ions in the solution. Several metal ions precipitate as hydrous oxide (hydroxides, oxides, or oxyhydroxides) under these conditions, lowering the concentration of free metal ions in the solution. For this reason, auxiliary complexing agents or ligands such as ammonia, tartrate, citrate, or triethanolamine are used in EDTA titrations to...
1.1K
01:12Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
1.7K
Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
1.7K
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
931
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
931