We describe a 64-year-old male of Indian descent with a history of atrial fibrillation who was started on warfarin after hospital admission for acute stroke. He received genotype-guided warfarin dosing as per the standard-of-care at our hospital, with daily dose recommendations provided by the pharmacogenetics service. Genotyping revealed the rare CYP2C9*1/*14 genotype and warfarin insensitive VKORC1 -1639GG and CYP4F2 433Met/Met genotypes. The patient received an initial warfarin loading dose of 4 mg for 2 days, followed by 2-3 mg/day for the following 11 days. He reached a therapeutic international normalized ratio on day 5, which was maintained over the following week. This report adds to the limited data of the effects of the CYP2C9*14 allele on warfarin dose requirements.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151614 | PMC |
| http://dx.doi.org/10.2217/pgs.14.47 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Vitamin K-dependent gamma-carboxyglutamic acid protein 1 promotes pancreatic ductal adenocarcinoma progression through stabilizing oncoprotein KRAS and tyrosine kinase receptor EGFR.
Clin Transl Med
January 2025
State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
Background: Vitamin K-dependent γ-glutamic acid carboxylation (Gla) proteins are calcium-binding and membrane-associated, participating in coagulation, bone turnover, and cancer biology. The molecular function of transmembrane proline-rich Gla proteins (PRRGs) remains unexplored.
Methods: Analysis of pancreatic ductal adenocarcinoma (PDAC) datasets, including transcription profiles, clinical data, and tissue microarrays, was conducted to evaluate PRRG1 expression and its clinical relevance.
A Mysterious Cause of Coagulopathy With Bleeding Diathesis.
Cureus
December 2024
Department of Internal Medicine IV, Hospital Professor Doutor Fernando Fonseca, Amadora, PRT.
Vitamin K is essential to produce functional vitamin K-dependent coagulation factors (prothrombin, factors VII, IX, and X). Vitamin K antagonists inhibit the normal activation of these factors, leading to bleeding manifestations of variable severity. Long-acting vitamin K antagonists or superwarfarins were developed as rodenticides and have a significantly longer half-life and greater potency when compared to warfarin.
View Article and Find Full Text PDFFor Atrial Fibrillation, DOACs Outperform Warfarin in Patients with Reduced Kidney Function.
J Am Board Fam Med
January 2025
From the Madigan Army Medical Center Family Medicine Residency, Tacoma, WA (RP, JC, AH).
At standard doses, direct oral anticoagulants (DOACs) were associated with a reduced risk of systemic embolism and intracranial hemorrhage (ICH) when compared with warfarin, with a greater derived benefit at lower creatinine clearance (CrCl-down to 25 mL/min). Lower doses of DOACs were associated with increased overall mortality without a significant decrease in ICH and incident bleeding when compared with standard dose DOACs and warfarin, across all CrCl down to 25 mL/min..
View Article and Find Full Text PDFEffectiveness and Safety of Dose-Specific DOACs in Patients With Atrial Fibrillation: A Systematic Review and Network Meta-Analysis.
Cardiovasc 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 PDFWarfarin-induced gastrointestinal bleeding with acute liver failure: A case report.
Medicine (Baltimore)
November 2024
Department of Pharmacy, The People's Hospital of Hezhou, Hezhou, China.
Rationale: Warfarin is the most commonly used drug in patients with mechanical valve replacement. Acute liver damage after warfarin is rare but potentially harmful. We present a case of warfarin-induced gastrointestinal bleeding with liver injury, pharmacy monitoring, and its therapy.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!