Family medicine physician's perspective on warfarin

[Zoltania]

Interesting blog post here, by a family physician who has experience with patients on warfarin:

Three Challenges in the Art of Prescribing Warfarin

He makes the same point I've seen Pellicle and others make here about avoiding overcorrection.

 

[Amy]

Fiddleheads!!

 

[pellicle]

Thanks for the post @Zoltania

Fiddleheads!!

I'm now trying to see what the vitamin k content is, but I have reservations that its higher than Kale or Collards or Spinach.

I've already seen someone eat 1kg of spinach with no significant observable effect on INR.

But overall I thought his response to that INR reading was entirely appropriate.

I think he's on the right track though when he says "So I simply tell my patients, “eat all the greens you want,"

however I see no clear evidence supporting this part "but be sure to keep the amount the same every day”.

Recall that the vitamin K doses need for reversal are in the order of 100 times the amount of vitamin K found commonly in foods. Its milligrams of K for reversal its usually micrograms in foods (1000 micrograms makes 1 milligram).

 

[pellicle]

I wonder what a "flowsheet" is

Unless you have a flowsheet that tells you that the last time you made that change, bad things happened, you will make the same poor choice again.​

however that not withstanding his words of documentation and reference are the cornerstone of what I preach too.