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Revista Médica La Paz

On-line version ISSN 1726-8958

Abstract

BERRIOS ARANDO, Abel; MENDOZA LOPEZ VIDELA, Jhosep Nilss; SALAZAR GONZALES, Gabriela Verónica  and  MENDUINA PARDO, Erish Shamir. WARFARIN OVERDOSE: CASE REPORT. Rev. Méd. La Paz [online]. 2019, vol.25, n.2, pp.65-69. ISSN 1726-8958.

Warfarin poisoning is uncommon but it can cause life-threatening bleeding. Vitamin K adapted dose resulting in a therapeutic INR until warfarin concentrations normalize would be ideal, however, this method can be complicated by a INR rebound and warfarin resistance. We present the case of a 75-year-old man with history of alcoholic consumption who started treatment with warfarin, concomitant to fluoxetine. Patient presented an INR>10 with major hemorrhage which successfully reverted after the conservative treatment with vitamin K and fresh frozen plasma. Overdose in patients who have an oral anticoagulant treatment associated to an underlying pathology makes treatment more complicated due to the difficulty of achieving a total reversal. Heparinization is an adequate option until warfarinization is restored, but leads to a prolonged hospitalization. As in this case report, events may occur with different complications exposing patients to a critical situation with imminent life risk; therefore, early diagnosis and timely therapeutic actions can prevent it.

Keywords : Warfarin; overdose; Vitamin K; Coagulopathy.

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