Epidemiological features of warfarin overdose and efficacy of prothrombin complex concentrates

Abstract

IntroductionDrug overdose-related symptoms are an important part of emergency department (ED) admissions. Drug overdoserelated side effects are more common than suicidal drug intoxications. Drug overdosing is generally related to narrow therapeutic index of the relevant drug. A recent study revealed that drug side effect-related ED admissions comprised 3.6% of admissions in the elderly; 33.3% of these admissions were due to warfarin, digoxin and insulin (Budnitz et al., 2007). A previous study also revealed that 65.7% of all drug intoxications that resulted in to ED admissions were drug overdoses. The most common drugs were warfarin, insulin, antiplatelet and oral hypoglycemic agents (Budnitz et al., 2007).Warfarin is the main vitamin K antagonist (VKA) used as oral anticoagulant, warfarin overdose is the most common cause of drug overdose admissions to ED, (Budnitz et al., 2011). Acenocumarol, phenprocoumon, fluindione and tecarfarin are other vitamin K antagonist derivates of coumarins (Ellis et al., 2009;Altunbaş et al., 2013). Following oral intake, warfarin is absorbed from the gastrointestinal system and binds to plasma albumin. Warfarin acts as an anticoagulant via inhibition of vitamin K-dependent monitoring to estimate the international normalized ratio

Clinical characteristics and overdose risk factors of patients hospitalized due to warfarin overdose

“…In a study by Erdogan et al, [19] comorbidities in patients presenting with warfarin overdose found HT as the most common, followed by coronary artery disease, and congestive heart failure. Shireman et al [20] also reported HT as the most common comorbidity.…”