"Coumadin is a registered trademark of Bristol-Myers Squibb Pharma Company," (Bristol- Meyers Squibb Company, 2008) and is a trade name for the generic medication warfarin sodium,commonly known as warfarin. This paper explores the use of Coumadin (warfarin) in clinical practice, focusing on both a typical use of warfarin (reducing the risk of thrombosis in patients diagnosed with atrial fibrillation) and on the potential for increased negative outcomes when patients receiving warfarin therapy experience intracranial bleeding.
[...] Poorly controlled drug levels resulting in INR ratios that are outside the therapeutic range bring with them the potential for devastating impacts on patients' health status. When INR ratios are kept within the therapeutic range, warfarin is a very safe drug. Coumadin Administration 9 However, warfarin does have the potential for significant adverse effects, including an increased incidence of cerebrovascular hemorrhage, and the potential to make any intracranial bleed a potentially much more serious event. In the final analysis, however, the benefits of warfarin therapy, when indicated, far outweigh the risks. Obviously it is very important to maintain therapeutic INR ratios. [...]
[...] Deglin, J. H., & Vallerand, A. H (Eds.). (2009). Davis's drug guide for nurses (Version 12.1 .2/ 2009.5 .5) [PDA software]. Philadelphia, PA: F. A. Davis Company. Fric-Shamji, E. C., Shamji, M. F., Cole, J., & Benoit, B. G. (2008). Modifiable risk factors for intracerebral hemorrhage. Canadian Family Physician, 1138-1139.e4. Garvin, R., Howard, E., & Crawford, P. (2006). Are major bleeding events from falls more likely in patients on warfarin?. Journal of Family Practice, 159-160. Glasheen, J. (2005). [...]
[...] The “annual risk of minor or major bleeding intracranial hemorrhage and death ( 0.6 (Glasheen p.96) for patients receiving warfarin therapy is not insignificant, Coumadin Administration and must be considered when assessing these patients. Although far less common, warfarin may also cause dermal necrosis, “hair loss, rash, gastrointestinal cramping, nausea, diarrhea, headaches, and fever” (Turner p. 44). The therapeutic window for warfarin is quite narrow, and is sharply influenced by concomitant intake of a wide variety of foods, herbs and medications. [...]
[...] The effects of oral warfarin therapy do not begin to set in for 12-24 hours, do not reach peak levels for 3-4 days and continue to impact the body's coagulation pathway for 2-5 days after the last dose of the medication is taken (Lilley, et al p. 423). One clinical indication for warfarin use is the prevention of blood clots, and the thus lowering the risk of thrombotic complications, especially pulmonary embolisms and brain attacks, in patients with atrial fibrillation. [...]
[...] administration of this Coumadin Administration medication. Clinical Background 3 Last year the author had the opportunity to work with a 65 year old male clinical patient who had slipped on ice and hit his head about 24 hours before reporting to the emergency department with confusion and an altered level of consciousness. This patient's medical history included sustained atrial fibrillation, for which he was taking a maintenance dose of warfarin. Upon admission the patient's INR level was tested and found to be Medication therapy was initiated to reverse his hypocoagulatory state, and a non-contrast computed tomography scan of his head was ordered. [...]
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