Patient Factors That Influence Warfarin Dose Response

Patient Factors That Influence Warfarin Dose Response
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影响华法林剂量反应的患者因素

DOI:
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发表时间:
2010
期刊:
Journal of pharmacy and practice
影响因子:
--
通讯作者:
P. White
P. White
中科院分区:
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文献类型:
--
作者:
P. White

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长期以来,华法林一直是治疗和预防静脉和动脉血栓形成的口服抗凝治疗的主要药物。华法林治疗指数的狭窄,以及影响国际标准化比率(INR)反应的因素复杂,使得华法林治疗的优化具有挑战性。在开始和维持治疗期间,确定适当的华法林剂量需要了解影响剂量反应的患者因素:年龄、体重、营养状况、急性和慢性疾病状况以及伴随的药物治疗和饮食的变化。这篇综述将考察影响华法林药代动力学和药效学的特定临床因素,以及药物遗传学在优化华法林治疗中的作用。
Warfarin has long been the mainstay of oral anticoagulation therapy for the treatment and prevention of venous and arterial thrombosis. The narrow therapeutic index of warfarin, and the complex number of factors that influence international normalized ratio (INR) response, makes optimization of warfarin therapy challenging. Determination of the appropriate warfarin dose during initiation and maintenance therapy requires an understanding of patient factors that influence dose response: age, body weight, nutritional status, acute and chronic disease states, and changes in concomitant drug therapy and diet. This review will examine specific clinical factors that can affect the pharmacokinetics and pharmacodynamics of warfarin, as well as the role of pharmacogenetics in optimizing warfarin therapy.
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