Warfarin Sensitivity Genotyping

Warfarin

August 2008

Warfarin had been utilized for quite some time for anticoagulation purposes. It is a coumarin anticoagulant as shown in the left panel.

It has been used clinically since the 1950s, so well over 50 years; and it is a racemic mixture of S- and R-isomers, 50% of each. The S-warfarin is 3- to 5-fold more active than the R-warfarin.

< Previous Slide

Warfarin

Next Slide >

 

Jump to section:

• Introduction
• Warfarin
• Warfarin Anticoagulation
• Warfarin
• Warfarin Monitoring
• Therapeutic Graph
• INR Variability in a 74 Year-old Male
• Warfarin and Bleeding Events
• Warfarin Metabolism
• Polymorphisms and Warfarin Sensitivity
• Polymorphisms and Warfarin Sensitivity
• Summary of Polymorphisms and Warfarin Pharmacokinetics⁵
• CYP2C9 Association Study
• PGx-Guided Warfarin Dosing⁷
• Warfarin Pharmacodynamics
• Polymorphisms and Warfarin Sensitivity
• VKORC1 Promoter Polymorphism⁶
• CYP2C9 and VKORC1 Interaction⁸
• Genotype-guided Warfarin Dosing⁹
• Genotype-guided Dosing
• Summary
• Orthopedic Algorithm¹⁰
• Significant Warfarin Drug Interactions
• Differential Effect of Drugs
• Patient Case: Rapidly Increasing INR
• References
• Questions?