title: When blood is thinner than water.
abstract: Antagonists of vitamin K dependant clotting factors are commonly used as treatment/prophylaxis for anticoagulation. Due to their narrow therapeutic window, a wide range of complications including death may occur. International normalized ratio (INR) is monitored to measure adequacy/excess of anticoagulation. There is a plethora of risk factors that may contribute to the uncontrollably high INR values. We describe our experience of a case of deep venous thrombosis wherein the patient had an overshoot of INR during anticoagulation therapy. We review the literature and discuss management in such scenarios.
authors.affiliation: Department of Internal Medicine, Princess Durru Shehvar Children's and General Hospital, Purani Haveli, Hyderabad, India.
authors.forename: Dilip
authors.initials: D
authors.lastname: Gude
authors.forename: Aslam
authors.initials: A
authors.lastname: Abbas
authors.forename: Hina
authors.initials: H
authors.lastname: Mohiuddin
mesh_terms: D000368:Aged; D000401:Aircraft; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D012307:Risk Factors; D014195:Travel; D020246:Venous Thrombosis / Q000150:complications* / Q000188:drug therapy*; D014812:Vitamin K / Q000037:antagonists & inhibitors*; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014812:Vitamin K; D014859:Warfarin