Cancer · UKMLA & AKT
Anticoagulation monitoring and dose adjustment
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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