Extreme warfarin intoxication secondary to possible covert drug ingestion.
A young adult male patient presented with an excessively prolonged prothrombin time (greater than 90 sec) following approximately two weeks of therapy with oral warfarin sodium, in doses between 2.5 and 5 mg/d. Repeated administration of vitamin K and fresh frozen plasma was required to reverse the anticoagulation and maintain a normalized prothrombin time. Serial warfarin plasma concentration measurements were used to interpret the apparently unusual prothrombin time response profile and to detect the possibility of covert drug ingestion.
Richmond
R G
RG
Smith Kline & French Laboratories, Raleigh, NC.
Sawyer
W T
WT
Aiello
P D
PD
Lindley
C M
CM
D000328:Adult; D006801:Humans; D008297:Male; D014812:Vitamin K / Q000097:blood / Q000627:therapeutic use; D014859:Warfarin / Q000097:blood / Q000506:poisoning*
D014812:Vitamin K; D014859:Warfarin