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Patient Education

  • Do NOT switch manufacturers of warfarin.

  • CMH Inpatients:

    • Direct patient education on warfarin will be provided by CMH pharmacists for CMH inpatients. Education and documentation of education provided will include:

      • Food, drug and complementary/alternative medication interactions with warfarin, signs of bleeding, importance of lab work, importance of informing all health care providers of use of warfarin, and recommendation for use of a Med ID/alert bracelet.

    • Direct patient education and patient educational materials emphasizing consistent intake of Vitamin K in the diet will be distributed to patients.

  • CMH Outpatients:

    • Patient counseling and written materials on warfarin will be provided by the CMH Outpatient Pharmacy on receipt of prescriptions.

    • Lexicomp patient leaflets are available to outpatient clinics for patients who will obtain prescriptions from sources other than the CMH Outpatient Pharmacy.

References:

Ansell J, et al. Pharmacology and Management of the Vitamin K Antagonists: American College of Cheset Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 133 (6Suppl): 160S-198S, 2008 Jun.

Bolton-Maggs P , Brook L. The use of vitamin K for reversal of over-warfarinization in children. Br J Haematol 2002; 118:924.

David, M., et al. Warfarin Therapy in Children. Thrombosis Interest Group of Canada. May 2004. http://www.tigc.org/eguidelines/warfarinchildren04.htm. Accessed 10/21/08.

Horton, JD, et al. Warfarin Therapy: Evolving Strategies in Anticoagulation. American Family Physician; 1999 Feb; 59(3):635-646. http://www.aafp.org/afp/AFPprinter/990201ap/635.html

Lexi-Drugs Online/Pediatric Lexi-Drugs Online, Warfarin, http://online.lexi.com/crlsql/servlet/crlonline, Copyright © 1978-2008 Lexi-Comp, Inc, Hudson, OH 44236

Monagle P. Chalmers E. Chan A. DeVeber G. Kirkham F. Massicotte P. Michelson AD. Antithrombotic therapy in neonates and children: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). [Journal Article] Chest. 133(6 Suppl):887S-968S, 2008 Jun.

Monagle P. Chan A. Massicotte P. Chalmers E. Michelson AD. Antithrombotic therapy in children: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. [Review] [487 refs] [Guideline. Journal Article. Practice Guideline. Review] Chest. 126(3 Suppl):645S-687S, 2004 Sep.

Roach ES. Golomb MR. Adams R. Biller J. Daniels S. Deveber G. Ferriero D. Jones BV. Kirkham FJ. Scott RM. Smith ER. American Heart Association Stroke Council. Council on Cardiovascular Disease in the Young. Management of stroke in infants and children: a scientific statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young. [Journal Article] Stroke. 39(9):2644-91, 2008 Sep.

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.