title: [Diagnosis and treatment of warfarin resistance].
abstract: Warfarin resistance is a phenomenon that patients need to take much higher than normally prescribed dosage of warfarin to maintain the target therapeutic international normalized ratio (INR) range, or even fail to reach the target INR. Warfarin resistance can be categorized in etiologic terms as hereditary vs acquired, or in pharmacologic terms as pharmacokinetic vs pharmacodynamic. Once warfarin resistance is diagnosed, the type of resistance should be determined as soon as possible so that treatment could be oriented toward the causes. Poor compliance, genetic mutations, concurrent medications that could decrease the absorption or increase the clearance of warfarin, and consumption of diet rich in vitamin K are the major reasons for warfarin resistance. Educating patients, increasing warfarin dosage and switching to other anticoagulants would be effective for warfarin resistance.
authors.affiliation: Institute of Clinical Pharmacology, Central South University, Changsha 410078, China.
authors.forename: Shenglan
authors.initials: S
authors.lastname: Tan
authors.forename: Xinmin
authors.initials: X
authors.lastname: Zhou
authors.forename: Zhi
authors.initials: Z
authors.lastname: Li
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Zhaoqian
authors.initials: Z
authors.lastname: Liu
authors.forename: Honghao
authors.initials: H
authors.lastname: Zhou
mesh_terms: D000925:Anticoagulants / Q000494:pharmacology*; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008661:Metabolism, Inborn Errors / Q000175:diagnosis* / Q000209:etiology / Q000235:genetics; D014812:Vitamin K / Q000008:administration & dosage; D064417:Vitamin K Epoxide Reductases / Q000235:genetics*
chemical_list: D000925:Anticoagulants; D014812:Vitamin K; C578523:VKORC1 protein, human; D064417:Vitamin K Epoxide Reductases