Scribd Logo
Upload

Welcome to Scribd!

  • 31 views

    Warfarin

    Uploaded by

    WAHYU NOFANDARI HERDIYANTI
    Warfarin is an oral anticoagulant with an onset of action of 24-72 hours and a peak effect reached within 5-7 days. It is almost completely absorbed orally and highly protein bound at 99%. It has a volume of distribution of 0.14 L/kg and is primarily metabolized in the liver by CYP2C9. Dosing is calculated based on factors like body surface area, age, smoking status, target INR level, and presence of other medications or medical conditions that impact warfarin levels and effect. Special dosing considerations are needed for patients with obesity, renal or liver impairment.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Warfarin

    Uploaded by

    WAHYU NOFANDARI HERDIYANTI
    31 views2 pages
    Warfarin is an oral anticoagulant with an onset of action of 24-72 hours and a peak effect reached within 5-7 days. It is almost completely absorbed orally and highly protein bound at 99%. It has a volume of distribution of 0.14 L/kg and is primarily metabolized in the liver by CYP2C9. Dosing is calculated based on factors like body surface area, age, smoking status, target INR level, and presence of other medications or medical conditions that impact warfarin levels and effect. Special dosing considerations are needed for patients with obesity, renal or liver impairment.

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Warfarin is an oral anticoagulant with an onset of action of 24-72 hours and a peak effect reached within 5-7 days. It is almost completely absorbed orally and highly protein bound at 99%. It has a volume of distribution of 0.14 L/kg and is primarily metabolized in the liver by CYP2C9. Dosing is calculated based on factors like body surface area, age, smoking status, target INR level, and presence of other medications or medical conditions that impact warfarin levels and effect. Special dosing considerations are needed for patients with obesity, renal or liver impairment.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    31 views2 pages

    Warfarin

    Uploaded by

    WAHYU NOFANDARI HERDIYANTI
    Warfarin is an oral anticoagulant with an onset of action of 24-72 hours and a peak effect reached within 5-7 days. It is almost completely absorbed orally and highly protein bound at 99%. It has a volume of distribution of 0.14 L/kg and is primarily metabolized in the liver by CYP2C9. Dosing is calculated based on factors like body surface area, age, smoking status, target INR level, and presence of other medications or medical conditions that impact warfarin levels and effect. Special dosing considerations are needed for patients with obesity, renal or liver impairment.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    You are on page 1of 2

    Warfarin

    Onset of action 24-72 jam (oral)

    Peak effect : Full therapeutic effect 5-7 hari. INR dapat meningkat dalam 36-72 jam

    Durasi 2-5 hari

    Absorpsi Oral : Rapid, sempurna

    Distribusi 0,14 L/kg

    Ikatan Protein 99%

    Metabolisme • Hepatik, secara utama melalui CYP2C9


    • Jalur minor melalui CYP2C8, 2C18, 2C19, 1A2, dan 3A4

    Ekskresi Urine (92%, umumnya sebagai metabolit)

    Volume Distribusi 0,14 L/kg

    Ikatan Protein 99%

    Rentang Terapeutik 1-11,8 mg/L

    Half-life eliminasi 20-60 jam

    Bioavabilitas 0,9

    Clearance (Cl) 3 ml/min


    Normal Obesitas Gangguan ginjal Gangguan Hati
    Dosis maintenance Dosis Dosis maintenance Dosis
    = e [0.613 + (0.425 x BSA) - maintenance = e = e [0.613 + (0.425 x BSA) - maintenance = e
    (0.0075 x age)  + (0.216  x target [0.613 + (0.425 x BSA) - (0.0075 (0.0075 x age)  + (0.216  x target [0.613 + (0.425 x BSA) - (0.0075

    INR) - (0.257 x amiodarone) + x age)  + (0.216  x target INR) - INR) - (0.257 x amiodarone) + x age)  + (0.216  x target INR) -

    (0.108  x smokes) + 0.0784  x  (0.257 x amiodarone) + (0.108  (0.108  x smokes) + 0.0784  x  (0.257 x amiodarone) + (0.108  x

    DVT/PE ] x smokes) + 0.0784  x  DVT/PE ] DVT/PE ] smokes) + 0.0784  x  DVT/PE ]

    BSA : BB0.425 x   TB BSA : BB0.425 x   TB BSA : BB0.425 x   TB BSA : BB0.425 x   TB


    (cm)0.725 x  0.007184 (cm)0.725 x  0.007184 (cm)0.725 x  0.007184 (cm)0.725 x  0.007184
    Target INR = 2-3 BB kg  GFR 30-59  Child-Pugh
    BMI = ml/menit
    TB2 m score > 10 :
    dikurangi 10% Dosis muatan
    Dewasa  GFR <30% – 50%
    dikurangi 19%  Child-Pugh
    score 8 – 9:
    Dosis muatan
    - 25%
     Dosis inisial : 2-5
    Males :

    Cl cr =( 137− Age ) ¿ ¿ClCr wanita : ClCr x 0,85


    mg/hari Female :
     Dosis Cl cr =( 1 46− Age ) ¿ ¿ClCr= ( 140−usia ) x BB
    pemeliharaan : 72 x SCr mg/dl
    2-10 mg/hari
    Anak Dosis Dosis Dosis maintenance Dosis
    maintenance = maintenance = e = e [0.613 + (0.425 x BSA) - maintenance = e
    e [0.613 + (0.425 x BSA) - [0.613 + (0.425 x BSA) - (0.0075 (0.0075 x age)  + (0.216  x target [0.613 + (0.425 x BSA) - (0.0075

    (0.0075 x age)  + (0.216  x x age)  + (0.216  x target INR) - INR) - (0.257 x amiodarone) + x age)  + (0.216  x target INR) -

    target INR) - (0.257 x (0.257 x amiodarone) + (0.108  (0.108  x smokes) + 0.0784  x  (0.257 x amiodarone) + (0.108  x

    amiodarone) + (0.108  x x smokes) + 0.0784  x  DVT/PE ] DVT/PE ] smokes) + 0.0784  x  DVT/PE ]

    smokes) + 0.0784  x  DVT/PE

    BSA : BB0.425 x   TB BSA : BB0.425 x   TB BSA : BB0.425 x   TB BSA : BB0.425 x   TB


    (cm)0.725 x  0.007184 (cm)0.725 x  0.007184 (cm)0.725 x  0.007184 (cm)0.725 x  0.007184
    Males :
     1-20 tahun :  Child-Pugh
    Cl cr =( 137− Age ) ¿ ¿ 0,55 x TB ( cm ) score > 10 :
    Female : ClCr=
    mg
    Cl cr =( 1 46− Age ) ¿ ¿ Scr
    dl
    Dosis muatan
    – 50% ( )
     0-1 tahun :  Child-Pugh
    0 , 45 x TB ( cm )score 8 – 9:
    ClCr=
    mg
    Scr
    dl - 25%( )
    Dosis muatan

     GFR 30-59
    ml/menit dikurangi
    10%
     GFR <30%
    dikurangi 19%

    You might also like