Warfarin Sensitivity Genotyping

Warfarin Monitoring

August 2008

Warfarin anticoagulation is monitored by measuring the prothrombin time (PT) and calculating the international normalized ratio (INR). In this particular case the INR equals the ratio of the patient prothrombin time normalized to the mean prothrombin time of a control group in your clinical setting and that is raised to the power of the international sensitivity index which takes into consideration of the availability of the thromboplastin used by the manufacturer of the kit.

Warfarin has a very narrow window for dosing. The best target for the INR for most patients is between 2 and 3.

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Warfarin Monitoring

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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?