Case 1 of 1Abnormal bleeding (e.g., thrombocytopenia, von Willebrand disease)
A 72-year-old man with atrial fibrillation has been taking warfarin (target INR 2.0-3.0) for 4 years with stable INR values. Ten days ago he completed a course of trimethoprim-sulfamethoxazole for a urinary tract infection. At a routine anticoagulation clinic visit he feels well and has no bleeding, bruising, or melena. He takes no antiplatelet agents or NSAIDs, has no history of bleeding, and his creatinine is normal. INR is 7.0 (0.9-1.1).
| Heart rate | 76/min (irregularly irregular) |
| Respiratory rate | 14/min |
| Temperature | 36.8 °C |
| O2 saturation | 98%, room air |
| Blood pressure | 138/82 mm Hg |
Question 1 of 3
Which one of the following is the most appropriate management at this visit?
Select 1. (0 / 1 selected)
A. Continue warfarin and repeat INR in 1 week
B. Prothrombin complex concentrate IV
C. Fresh frozen plasma IV
D. Vitamin K1 SC
E. Reduce weekly warfarin dose by 50% without holding doses
F. Hold warfarin for 1-2 doses and monitor INR
G. Vitamin K1 10 mg IV
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