Warfarin (Coumadin, Jantoven) Overdose
Description
Warfarin inhibits vitamin K dependent coagulation factors. It is used to thin the blood in patients who have experienced blood clots, or for patients with heart arrhythmias (atrial fibrillation) or metal heart valves. An overdose can occur intentionally or accidentally. The disorder causes excessive bleeding and can be lethal if left untreated. There is a delay from time of ingestion to effect on the coagulation system.
Symptoms
The disorder can affect any body part and are related to excess bleeding including: Nosebleeds, bleeding gums, vomiting blood, vomiting coffee ground material, bloody stools, black stools (melena), easy bruising, fainting, confusion, weak pulse, intercerebral bleeding.
Tests
A history and physical exam will be performed. The protime (PT/INR) blood test measures the vitamin K dependent coagulation pathway and can diagnose the disorder. There is a delay from time of ingestion to effect on the coagulation system.
- CBC
- Chem 12
- BHCG
- CT Scan
Treatment
The goal of therapy is to support the vital signs and reverse the bleeding. Patients may require intravenous fluids and blood transfusions. Treatment to reverse the effects of the warfarin include vitamin K, fresh frozen plasma and factor IX concentrate administration. For more information and help call your local poison center at 1-800-222-1222.
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