An experimental conditions is described in which the i.p. administration to rats of irritants produces a misleading increase of the anticoagulant effect of warfarin. Groups of 10 adult Wistar rats were treated i.p. or i.v. with HCl 0.1N plus warfarin p.o.; 24 hr after warfarin administration, prothrombin time was determined on citrate blood specimens and the animals were submitted to autopsy. When HCl is given i.p., a significant increase of prothrombin time is observed. On the contrary following i.v. administration no interference with the anticoagulant effect of warfarin is observed. Abdomen exploration of rats shows the presence of serum exudate following i.p. but not i.v. administration of HCl. The synergistic effect of i.p. administration of HCl on anticoagulant effect of warfarin appears an experimental artifact, probably attributable to a non-specific local irritating effect. This result stresses the need of caution in interpreting animal data indicating a synergism with oral anticoagulants.
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Biometrics
January 2025
Department of Statistics and Data Science, National University of Singapore, Singapore 117546, Singapore.
Pharmacogenomics stands as a pivotal driver toward personalized medicine, aiming to optimize drug efficacy while minimizing adverse effects by uncovering the impact of genetic variations on inter-individual outcome variability. Despite its promise, the intricate landscape of drug metabolism introduces complexity, where the correlation between drug response and genes can be shaped by numerous nongenetic factors, often exhibiting heterogeneity across diverse subpopulations. This challenge is particularly pronounced in datasets such as the International Warfarin Pharmacogenetic Consortium (IWPC), which encompasses diverse patient information from multiple nations.
View Article and Find Full Text PDFCardiovasc Ther
January 2025
College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan-si, Gyeonggi-do, Republic of Korea.
Dose adjustments of direct-acting oral anticoagulants (DOACs) for atrial fibrillation are based on pivotal clinical trials assessing their effectiveness and safety in controlled settings. However, the appropriateness of these dosing strategies in real-world practice is uncertain. The purpose of this study is to compare the effectiveness and safety of dose-specific DOACs with those of warfarin.
View Article and Find Full Text PDFBackground: The guidelines recommend anticoagulation management with uninterrupted warfarin or direct thrombin inhibitors (DTIs) during the atrial fibrillation (AF) ablation periprocedural period.
Objectives: To clarify the Japanese real-world latest periprocedural anticoagulation management during AF ablation.
Methods: This multicenter observational study included 6232 consecutive AF patients (68.
Urol Case Rep
January 2025
Consultant of Endourology and MIS at King Fahad Hospital of University, College of Medicine Imam Abdulrahman bin Faisal University, Saudi Arabia.
Spontaneous, non-traumatic bleeding into the subcapsular and perirenal space is a rare and potentially fatal condition known as Wunderlich syndrome (WS). It has a variety of causes including the usage of anticoagulation. Many anticoagulants including warfarin can interact with other medication and lead to potentially fatal complications, Herein, we report a case of a 47 year old female on warfarin who developed subcapsular renal hematoma and retroperitoneal hematoma after the completion of ciprofloxacin treatment course.
View Article and Find Full Text PDFKidney Int Rep
January 2025
Department of Pharmacy, NewYork-Presbyterian Hospital, New York, USA.
Direct oral anticoagulant (DOAC) use has significantly increased because major medical organizations endorse their role for conditions in which anticoagulation is indicated. Owing to important pharmacokinetic properties, the use of apixaban and rivaroxaban requires careful consideration in at-risk populations such as those with kidney disease. Both apixaban and rivaroxaban undergo some degree of renal elimination, and thus total drug exposure is increased in patients with renal insufficiency and/or those undergoing renal replacement therapy (RRT).
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