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Warfarin [15] Papaya extract Carica papaya: Warfarin Damage to GI tract mucous membranes [3] Kava: kava-kava Piper methysticum: Sedatives, sleeping pills, antipsychotics, alcohol [15] Milkvetch: Astragalus: Astragalus may interact with medications that suppress the immune system, such as cyclophosphamide. [24] It may also affect blood sugar ...
The major side effect of warfarin use is bleeding. Risk of bleeding is increased if the INR is out of range (due to accidental or deliberate overdose or due to interactions). [45] Many drug interactions can increase the effect of warfarin, also causing an overdose. [27]
Warfarin necrosis is a rare but severe complication of treatment with warfarin or related anticoagulants. [2] The typical patient appears to be an obese, middle aged woman (median age 54 years, male to female ratio 1:3). [1] [3]: 122–3 This drug eruption usually occurs between the third and tenth days of therapy with warfarin derivatives. [1]
Type A: augmented pharmacological effects, which are dose-dependent and predictable [5]; Type A reactions, which constitute approximately 80% of adverse drug reactions, are usually a consequence of the drug's primary pharmacological effect (e.g., bleeding when using the anticoagulant warfarin) or a low therapeutic index of the drug (e.g., nausea from digoxin), and they are therefore predictable.
In the formation of the active metabolite additional metabolites have been identified and they are dihydrothienopyridinium (M5) and thienodihydropyridinium metabolites (M6). These metabolites may be responsible for the toxic side effects of ticlopidine. [18] Metabolism of ticlopidine, clopidogrel and prasugrel to an active metabolite.
In this case, both the therapeutic and toxic targets are the same. To avoid toxicity during treatment, many times the drug needs to be changed to target a different aspect of the illness or symptoms. Statins are an example of a drug class that can have toxic effects at the therapeutic target (HMG CoA reductase). [1]
Fetal warfarin syndrome is a disorder of the embryo which occurs in a child whose mother took the medication warfarin (brand name: Coumadin) during pregnancy. Resulting abnormalities include low birth weight , slower growth , intellectual disability , deafness , small head size , and malformed bones , cartilage , and joints .
Side effects may include bleeding, most commonly from the nose, gastrointestinal tract (GI) or genitourinary system. [2] Compared to the risk of bleeding with warfarin use, direct factor Xa inhibitors have a higher risk of GI bleeding, but lower risk of bleeding in the brain . [ 2 ]