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GUIDELINES & PROTOCOLS ADVISORY COMMITTEE warfarin Therapy - Man eldment During Invasive Procedures and operation effective participation: October 1, 2010 Scope This guideline is directed towards those physicians problematical in the management of warfarin therapy when the patient (19 years of age and over) begs invasive procedures and surgery. For patients younger than 19, partake to the BC Childrens hospital anticoagulation protocol. A summary (Appendix A) of this catalogue in flowchart change is included.

Therapeutic Measures for Reversal of Warfarin Therapy: VitaminK Intravenous(IV)deliver yisthefastestandmost true(p)waytoobtaintheeffectofvitaminK Intramuscular(IM)orsubcutaneousdeliveryshouldbeavoided Iftheprocedureisin morethan24hours,thereisnodifferencebetween usingIVandoral(PO) Usefulforpost-operativeperiodsaswell overweening loony toonsofvitaminKcanleadtodifficultywithre-anticoagulation EffectonINRisobservedafter812hours,dependingonrouteofadministration Recommendeddoses: oral1to2mg IV5mgin50ccnormalsalineinfusedover30minutes VirallyInactivatedPlasma-Derived set ashore down(Octaplex®) Useonlyinconsultationwithspecialist preferredproductforrapidreversalofwarfarinwhenavailable continuationofactionis~6hours,typicallyonlyonedoseisneeded Virallyinactivatedplasma-derivedconcentratecontainingfactorsII,VII,IX,XandProteinCand ProteinS essentialbeusedinconjunctionwithIVvitaminK IndicatedforimmediateINRreversalinpatients: withactive,seriousbleed ing whorequiresurgerywithinnext6hours! Containsheparinandiscontraindicatedin...If you sine qua non to get a full essay, order it on our website: BestEssayCheap.com

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