• Pharmacotherapy · Mar 2008

    Vitamin K-independent warfarin resistance after concurrent administration of warfarin and continuous enteral nutrition.

    • Roland N Dickerson, Wesley M Garmon, David A Kuhl, Gayle Minard, and Rex O Brown.
    • Department of Clinical Pharmacy, University of Tennessee Center for the Health Sciences, Memphis, Tennessee 38163, USA. rdickerson@utmem.edu
    • Pharmacotherapy. 2008 Mar 1;28(3):308-13.

    Study ObjectiveTo assess the influence of withholding continuous enteral nutrition for 1 hour before and after warfarin administration compared with the coadministration of warfarin with continuous enteral nutrition on changes in international normalized ratios (INRs).DesignRetrospective, crossover case series.SettingIntensive care units of a university-affiliated medical center.PatientsSix adults who required nutritional support for at least the first 10 consecutive days of warfarin therapy; during that 10-day period, they had a period of at least 3 consecutive days during which the enteral feeding was withheld for 1 hour before and after warfarin administration, and had a period of at least 3 consecutive days when feedings were not withheld during warfarin administration. Patients with advanced liver disease and those who received therapies, during the observation period, that significantly alter warfarin metabolism were omitted from the study.Measurements And Main ResultsThe change in INR during the 3-day observation period when feedings were withheld for 1 hour before and after warfarin administration was significantly different versus the change in INR during coadministration of warfarin with continuous feeding (mean +/- SD 0.74 +/- 0.66 vs -0.13 +/- 0.81, p < or = 0.05). This difference in INR response occurred despite the administration of similar dosages of warfarin (5.6 +/- 2.1 vs 5.7 +/- 2.1 mg/day, p>0.05). Also noted was a clinically irrelevant, but statistically significant, difference in vitamin K intake between treatment periods (77 +/- 36 mug/day when feedings were withheld vs 102 +/- 28 microg/day when feedings were not withheld, p < or = 0.05).ConclusionContinuous enteral nutrition should be withheld for 1 hour before and after warfarin administration to prevent enteral nutrition-associated warfarin resistance.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…