A spectrofluorimetric method is described for the determination of drugs containing active methylene groups adjacent to carbonyl groups. The method was applied successfully to the determination of warfarin sodium in laboratory-prepared mixtures, in commercial tablets, and in spiked human plasma samples. Finally, the method was applied to the determination of the steady-state concentration of warfarin sodium in the blood of a hospitalized patient. The method involves the reaction of warfarin sodium with 0.2 ml (0.4 x 10(-3)M) N1-methylnicotinamide chloride reagent in the presence of 3 mL 1.0N NaOH and cooling in ice for 8 min, followed by adjustment of the pH to 2.0, using formic acid and heating for 4 min, whereby a highly fluorescent reaction product is produced. The optimal wavelengths of excitation and emission were determined by using a synchronous wavelength search and found to be 284 and 354 nm, respectively. The standard curves were linear over a concentration range of 50-1500 ng/mL in both aqueous solutions and spiked human plasma samples. The mean recoveries (+/- standard deviation) were 101.157 (+/-1.33) and 95.73 (+/-1.88%) for aqueous solutions and spiked human plasma samples, respectively. The method showed good specificity and precision. The proposed method is simple and economical because of its minimal instrumentation and chemicals requirements. Nevertheless, it is highly sensitive, specific, and reproducible. Accordingly, it is suitable for quality-control applications, drug monitoring, and bioavailability and bioequivalency studies.
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Comput Biol Med
January 2025
Department of Medicine (HSRD), Baylor College of Medicine, Houston, TX, USA. Electronic address:
This study highlights the importance of evaluating warfarin dosing in diabetic patients, who require careful anticoagulation management. With rising rates of diabetes and cardiovascular diseases, understanding the factors influencing warfarin therapy is vital for improving patient outcomes and reducing adverse events. Data was sourced from the IWPC dataset, examining characteristics such as age, gender, diabetes status, indication for warfarin, weight, and height.
View Article and Find Full Text PDFClin Appl Thromb Hemost
January 2025
Department of Pharmacy Practice, Loma Linda University School of Pharmacy, Loma Linda, CA, USA.
Limited available evidence comparing DOACs with warfarin suggests efficacy and safety of DOACs for CVT. We aimed to evaluate whether a specific DOAC is preferred for the treatment of CVT. This retrospective cohort study included adult patients with CVTs between September 2018 and September 2022 treated with a DOAC.
View Article and Find Full Text PDFAm J Case Rep
January 2025
Department of Clinical Diagnostic Laboratories, Hospital Al-Sultan Abdullah, Puncak Alam, Selangor, Malaysia.
BACKGROUND Lupus anticoagulants (LA) can interfere with routine coagulation tests such as the activated partial thromboplastin time (aPTT) and prothrombin time (PT). The international normalized ratio (INR) is derived from PT and is used to monitor warfarin therapy. A positive LA result is one of the laboratory criteria of the 2023 ACR/EULAR antiphospholipid syndrome (APS) classification criteria.
View Article and Find Full Text PDFCochrane Database Syst Rev
January 2025
Department of Pharmacy Practice, University of Connecticut, Storrs, CT 06269, USA.
Background: Guideline-recommended strategies to interrupt chronic anticoagulation with warfarin or direct oral anticoagulants (DOAC) during the perioperative period of cardiac implantable electronic device (CIED) surgery differ worldwide. There is uncertainty concerning the benefits and harms of interrupted and uninterrupted anticoagulation in patients undergoing CIED surgery.
Objectives: To assess the benefits and harms of interrupted anticoagulation (IAC) with either warfarin or DOAC in the perioperative period of CIED surgery versus uninterrupted anticoagulation (UAC), with or without heparin bridging, during an equivalent time frame, for CIED surgery.
Int J Urol
January 2025
Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa, Japan.
Introduction: We investigated the subsequent trends in age and antithrombotic therapy in patients who underwent transurethral resection of bladder tumor (TURBT) and examined the rate of perioperative complications.
Methods: Medical records of patients who underwent TURBT were retrospectively analyzed. We arbitrarily divided the observation years into three periods (I: 2007-2013, II: 2014-2018, and III: 2019-2023) to compare the trends in age and frequency of perioperative complications after TURBT between patients taking and those not taking antithrombotic drugs.
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