title: Patient factors that influence warfarin dose response.
abstract: Warfarin has long been the mainstay of oral anticoagulation therapy for the treatment and prevention of venous and arterial thrombosis. The narrow therapeutic index of warfarin, and the complex number of factors that influence international normalized ratio (INR) response, makes optimization of warfarin therapy challenging. Determination of the appropriate warfarin dose during initiation and maintenance therapy requires an understanding of patient factors that influence dose response: age, body weight, nutritional status, acute and chronic disease states, and changes in concomitant drug therapy and diet. This review will examine specific clinical factors that can affect the pharmacokinetics and pharmacodynamics of warfarin, as well as the role of pharmacogenetics in optimizing warfarin therapy.
authors.affiliation: Legacy Health Anticoagulation Clinics, Portland, OR, USA. pwhite@lhs.org
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: White
mesh_terms: D000367:Age Factors; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001835:Body Weight; D015897:Comorbidity; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D006801:Humans; D019934:International Normalized Ratio; D010597:Pharmacogenetics; D013927:Thrombosis / Q000188:drug therapy* / Q000453:epidemiology; D014859:Warfarin / Q000008:administration & dosage* / Q000009:adverse effects* / Q000493:pharmacokinetics
chemical_list: D000925:Anticoagulants; D014859:Warfarin