Everything You Need to Know About Warfarin

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One of our members (RCB) started taking warfarin in 1960. It occurred to me that I went to pharmacy school during that era. I decided to look up what it said about warfarin in my pharmacology book. This is what I learned about warfarin in pharmacy school. Keep in mind that the much-touted leader of the Free World, The President of The United States Dwight Eisenhower was given warfarin in 1955.

Medical Pharmacology: Second Edition copyright 1964 by Andres Goth, M.D. was the textbook that I used in pharmacy school. The chapter on anticoagulant drugs covers ten pages and has nineteen references cited. Of those ten pages, one is devoted to schematics of various chemical structures and one contains the references. This is the entire reference to warfarin:
There is considerable controversy about the usefulness of anticoagulants in diseases of coronary and cerebral vessels. On the other hand, the drugs are considered more useful in thrombophlebitis.
In myocardial infarction favorable results have been claimed,(Footnote#19) but many competent cardiologists now feel that the use of anticoagulants should be reserved for severe cases only.
Many clinical investigators in this country prefer the coumarins and find that warfarin (Coumadin) is one of the best from the standpoint of ease of regulation. It is a good rule for the physician to use the anticoagulant with which he is thoroughly familiar and only if he has facilities for one-stage prothrombin time determinations.

Those 109 words are the total of what many pharmacists, physicians and nurses still practicing today were taught in school. The lone reference footnoted was published in 1954. That was ten years before the book was published.
 
I think maybe it's time for an update? What that said is just about the reactions we get out of our providers, so they must still use that paragraph as the "Set in stone" standard. :(
 
I just renewed my Coumadin prescription yesterday and was glancing at the material that my pharmacy (CVS) includes with the meds. It describes Coumadin as "a blood thinner that makes the blood flow through the blood vessels easier ......" Isn't that the darndest - if your pharmacy doesn't know then that sets a fine example for the docs and the patients. Maybe the ideal INR should be 10W30 ?? Chris
 
I just sent an e-mail to CVS - "...is this really the misinformation that you are putting out?"
 
Dear Mr. Al Lodwick :

Thank you for your recent contact with CVS.com. We appreciate your
feedback. After reviewing your comment, we have forwarded your
information to the appropriate party within CVS.

Thank you for your time and thank you for shopping with CVS.com.

Sincerely,

Michael A. Renaud
Customer Care Department

WE SHALL SEE IF THE APPROPRIATE PARTY EVER RESPONDS.
 
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Hey Al-

I bet you'll get some CVS coupons in the mail to go along with your form letter. You know, "thank you for shopping at CVS", rewards.
 
If I do, I'll give them away at the reunion because we do not have CVS in Colorado.
 
CVS reply:

I think they are to be commended for agreeing that this is out-dated terminology and being willing to update it.


We at CVS/pharmacy Clinical Services appreciate your comments
regarding our warfarin patient education material. Many patient
education materials make use of the term "blood thinner" as a matter of
reference to familiar lay language. However, after a clinical review of
this issue we agree that identifying warfarin as a "blood thinner" does
not appropriately reflect the true mechanism of action of warfarin and
should therefore be modified. Our new explanation will incorporate more
descriptive terminology while maintaining an appropriate reference to
lay language.

Your willingness to contact us regarding this matter is a credit to
your concern for both patient care and education. This attention to
detail not only improves pharmaceutical care but healthcare as a whole.

If you have any further questions in regards to this matter please feel
free to contact us.

Sincerely,

CVS Clinical Services
 
WOW

WOW

All that in 4 days. CVS is certainly to be commended.

Hey Al - I'll bet they'd give you a job!:D
 
I told my boss that he would be doing me a favor if he fired me. When my students graduate, they get about $4 per hour more than I do.
 
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