"Warfarin" - overdose and its treatment
The drug "Warfarin" can be found in the medicine cabinet of many people over 45 years old. And all because the diseases of the cardiovascular system are still leading in the morbidity and mortality of the population. Therapists, cardiologists, vascular surgeons, neurologists often prescribe this drug because it is the most affordable in its category. "Warfarin" is a very strong medicine, and getting an overdose is not so difficult, especially if the patient is self-medicated.
"Warfarin" is heard by many, but not everyone knows how it works. What is this drug? What benefit and harm can Warfarin carry for a person? How to determine the drug overdose and what first aid should the victim have? It is desirable to know the answers to these questions to everyone, because it is forewarned, therefore, it is armed.
Who and for what is assigned "Warfarin"
"Warfarin" is an anticoagulant that has an artificial origin and has an indirect effect. Anticoagulants are drugs that reduce blood clotting. Indirect "Warfarin" is called because it acts in the liver, blocking the action of vitamin K, reducing the production of clotting factors II, VII, IX and X and some proteins. Coagulation factors are formed, but they perform poorly their functions.
"Warfarin" refers to drugs with a delayed period of action - blood coagulability begins to decrease only 3-5 days after the start of taking. The maximum effect of the drug Warfarin develops in a week. This effect is explained by the fact that in the blood for some time the normal clotting factors remain, and then they are replaced by non-functioning factors.
"Warfarin" is prescribed for the purpose of treatment and prevention of thrombosis, thromboembolism, stroke, with inflammation of the veins. Also it is shown to persons who have suffered a myocardial infarction and those who have a heart valve.
Where else does Warfarin apply? First, this drug was used as a poison for rodents. And to this day it is a part of drugs that destroy mice and rats, and is used in warehouses, in production.
"Warfarin" pharmacy is a white tablet without taste and smell. A poison is a powder, which is mixed into food-bait.
In what cases is an overdose possible with the drug Warfarin
The dose for each person is selected individually by the doctor, based on the results of the analysis on INR (the international normalized relationship). MNO is an indicator that reflects prothrombin time (blood coagulation rate). Normally, in a healthy person, it is 0.9-1.1. Taking Warfarin MNO should be kept within 2.0-3.0.
How can I get an overdose with warfarin? If it is a rat poison, the most likely victim will be a small child or a pet, by carelessly eating the bait.
Overdose of the drug Warfarin may occur in cases when:
- neglect the doctor's recommendations and engage in self-medication;
- the patient suffers from a mental disorder or forgetfulness;
- the medicine is used as a suicidal drug.
Tablets "Warfarin" are small and divided by risks into 4 parts - this is no accident. If such a small tablet needs to be divided into 4 parts, it means that the substance is potent.
Symptoms of an overdose of warfarin
Symptoms of an overdose with the drug "Warfarin" will be associated with increased bleeding and bleeding. As already mentioned earlier, the first signs of an overdose appear only on the third day after the start of taking and depend on the dose of the medicine taken. If one-time was used, for example, a whole tablet "Warfarin" instead of quarters, then there are no manifestations, maybe not. Another thing is if the dosage is exceeded systematically for a long time.
When the dose of Warfarin is exceeded, the following side effects develop:
- bleeding from the nose;
- women become more abundant and prolonged menstruation;
- large-sized bruises appear with minor bruises, do not resolve for a long time;
- hemorrhages in the sclera of the eye;
- hemorrhoidal hemorrhages;
- prolonged unceasing bleeding with various minor injuries.
For the emergence of bleeding or hemorrhage, you need some provoking factors, for example, scratches, abrasions, damage to the hemorrhoids. Bleeding gums occurs when cleaning teeth, bleeding in sclera, or bleeding from the nose - with increasing blood pressure. With a long overdose of the drug Warfarin, bruising and hemorrhages begin to appear, even if they were not preceded by bruises.
What does the patient feel? A person who abuses Warfarin can feel unexpectedly uncomfortable weakness, if the loss of blood is systematic, then anemia develops over time. This is especially true for women with prolonged and profuse bloody discharge.
The most terrible complication with an overdose of warfarin can be internal bleeding. This is especially true of people:
- with peptic ulcer of stomach and duodenum;
- with urolithiasis and cholelithiasis;
- with malignant tumors;
- diseases of the lungs, accompanied by hemoptysis, etc.
Internal bleeding is more difficult to detect and stop. It can quickly end in death if you do not take immediate action.
Treatment of overdose with the drug "Warfarin"
Poisoning with warfarin is a condition requiring medical attention. Self-treatment can be not only ineffective, but also harmful.
The antidote of warfarin is vitamin K, registered in Russia under the name "Vikasol". It exists both in tablets and in the form of injectable solutions.
It is necessary to conduct laboratory monitoring, because the treatment of a warfarin overdose is carried out under the control of the INR level.
The tactics of treatment, with an overdose of warfarin, is selected depending on the level of INR.
- If the INR is in the range of 3 to 4, then simply lower the dose of the drug. "Vikasol" is not necessary to appoint.
- When the INR level is from 4 to 6, vitamin K is not yet prescribed, but it is recommended to skip one dose of Warfarin and reduce the temporary follow-up.
- At the values of INR 6-10 "Warfarin" is canceled, "Vikasol" is prescribed for 2 mg in tablets, until the INR is less than 5.
- If the INR is more than 10, Warfarin is necessarily canceled, and Vikasol is prescribed at a dose of 5 mg orally.
These recommendations are effective only in the absence of life-threatening bleeding. When an overdose of the drug "Warfarin", which led to severe bleeding, you need:
- introduce "Vikasol" in a dose of 5-10 mg intravenously;
- infuse freshly frozen plasma;
- inject intravenously dribbling factors of blood clotting.
Such conditions can arise when attempting suicide by swallowing a large number of tablets. In this case, it is recommended first of all to wash the victim's stomach and give a large number of activated carbon tablets.
What to do if an overdose of Warfarin is insignificant? At home, you can follow a diet rich in vitamin K. This substance is in sufficient quantities:
- in parsley and other greens;
- in green vegetables;
- in vegetable oil.
An overdose of warfarin can pass without manifestations and consequences, and can end badly. The main rule of taking this medication is regular medical supervision and control of blood clotting. The main criterion is the INR. If bleeding does occur, you should seek medical help. Treatment for an overdose of warfarin is carried out depending on the clotting factor. The antidote of warfarin is the drug "Vikasol", which is the main drug in the treatment of overdose.