Cancer · UKMLA & AKT
Anticoagulation monitoring and dose adjustment
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise anticoagulation monitoring and dose adjustment — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Warfarin inhibits vitamin K-dependent factors II, VII, IX, X - factor VII (shortest half-life ~6h) is depleted first, prolonging the PT/INR
- PT/INR - prolonged at therapeutic doses (extrinsic pathway, factor VII)
- APTT - normal at therapeutic doses; factor IX reduction is less marked; both PT and APTT prolonged only in warfarin overdose
- INR (International Normalised Ratio) - primary monitoring test; checked at initiation then at least every 12 weeks once stable
Therapeutic warfarin = prolonged PT, normal APTT. Overdose = both prolonged.
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