|LETTER TO EDITOR
|Year : 2019 | Volume
| Issue : 9 | Page : 3071
Warfarin overdose with a side of munchausen
Saint James School of Medicine, 1480 Renaissance Drive, Park Ridge, Chicago, Illinois, USA
|Date of Submission||29-Jun-2019|
|Date of Decision||21-Jul-2019|
|Date of Acceptance||22-Aug-2019|
|Date of Web Publication||30-Sep-2019|
Dr. Denelle Mohammed
Saint James School of Medicine, 1480 Renaissance Drive, Suite 300, Park Ridge, IL 60068
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mohammed D. Warfarin overdose with a side of munchausen. J Family Med Prim Care 2019;8:3071
The article entitled, “Dying to be Ill: Munchausen meets warfarin overdose” was an illuminating and interesting read. The article evaluated a method of warfarin overdose that is not typically at the top of the list for many physicians. I commend the authors on publication of a piece that embodies several aspects of primary care in one case report.
I wish to provide some added information about treatment of warfarin overdose based on severity. For minor bleeding, withholding warfarin with observation is more than enough. The treatment of warfarin overdose with severe bleeding usually begins with slow infusion of 10 mg of Vitamin K intravenously typically over the course of 20 to 60 minutes. For more severe cases of bleeding, including those with an INR>2 as seen in this case report, patients should be treated with 4-factor prothrombin complex concentrate. The dosage for patients with an INR greater than 6, such as the patient in this case report is 50 units/kg. When treatment has commenced, the only thing left to do is monitor patients with PT/INR at 30-minute intervals.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Leissinger CA, Blatt PM, Hoots WK, Ewenstein B. Role of prothrombin complex concentrates in reversing warfarin anticoagulation: A review of the literature. Am J Hematol 2008;83:137.
Holbrook A, Schulman S, Witt DM, et al
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