Practical management of coagulopathy associated with warfarin

@article{Garcia2010PracticalMO,
  title={Practical management of coagulopathy associated with warfarin},
  author={David A. Garcia and Mark Andrew Crowther and Walter Ageno},
  journal={BMJ : British Medical Journal},
  year={2010},
  volume={340}
}
When choosing a management strategy for a patient who is being treated with a vitamin K antagonist and presents with an INR outside the therapeutic range, consider the risk of both bleeding and thrombosis 
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The role of anti-platelet agents, non-steroidal anti-inflammatory drugs and cyclo-oxygenase-2 inhibitors in worsening warfarin-related bleeding needs emphasis.
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Vitamin K therapy is an effective treatment for INR prolongation in patients with coumarin‐associated coagulopathy; coagulation factor replacement is required, in addition, in Patients with major bleeding or with indication for immediate correction of their INR.
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TLDR
In patients receiving warfarin who have asymptomatic excessive prolongations in their INR results, 1 mg of oral vitamin K reliably reduces the INR to the therapeutic range within 24 h, suggesting this therapy is more convenient, less expensive, and might be safer than parenteral vitamin K.
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