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10.1310/hpj4911-1044 http://scihub22266oqcxt.onion/10.1310/hpj4911-1044 C4319805!4319805 !25673894     free     free     free Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\25673894 .jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117       Hosp+Pharm 2014 ; 49 (11 ): 1044-8 Nephropedia Template TP {{tp|p=25673894 |t=2014. Warfarin-induced skin necrosis |pdf=|usr=}}{{25673894 }} gab.com Text Warfarin-induced skin necrosis JO: Hosp Pharm http://www.kidney.de/pget.php?&tw=1&pmid=25673894 #FOAvip BACKGROUND: Warfarin is a frequently used oral anticoagulant in the treatment and prevention of various medical conditions. One uncommon adverse effect that can occur following the initiation of therapy is warfarin-induced skin necrosis. Because it is a rare effect with an undetermined pathophysiology of disease, the treatment is not well established. CASE: A 52-year-old female was prescribed warfarin and enoxaparin for a newly diagnosed deep vein thrombosis (DVT) in the left lower extremity. On day 4 of therapy, the patient had a supra-therapeutic international normalized ratio (INR), prompting the discontinuation of enoxaparin and a decrease in the warfarin dose. The patient returned to the emergency department on day 7 of treatment with a purple, cold, and extremely painful right foot with punctate areas of necrosis and petechiae proximal to the discoloration. The patient's INR was found to be 10.64. Following the diagnosis of warfarin-induced skin necrosis, the patient was administered vitamin K intravenously and fresh frozen plasma (FFP) to reverse the effects of warfarin and promote protein C and S synthesis. Once the patient's INR was no longer supratherapeutic, subcutaneous enoxaparin was re-started as treatment for the known recent DVT. The patient's necrotic foot began to improve and she was discharged home with an anticipated full recovery. CONCLUSIONS: Based on the proposed pathophysiology of disease, adequate bridge therapy may decrease the likelihood of developing this life-threatening condition. Early recognition and treatment with intravenous vitamin K, FFP or 4-factor prothrombin complex concentrate, and continued wound care are essential to prevent further complications. Twit Text FOAVip Warfarin-induced skin necrosis ????Hosp Pharm http://www.kidney.de/pget.php?&tw=1&pmid=25673894 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=25673894 #FOAvip English Wikipedia <ref>{{Cite pmid|25673894 }}</ref> Warfarin-induced skin necrosis #MMPMID25673894 Pourdeyhimi N ; Bullard Z Hosp Pharm 2014[Dec]; 49 (11 ): 1044-8 PMID25673894 show ga BACKGROUND: Warfarin is a frequently used oral anticoagulant in the treatment and prevention of various medical conditions. One uncommon adverse effect that can occur following the initiation of therapy is warfarin-induced skin necrosis. Because it is a rare effect with an undetermined pathophysiology of disease, the treatment is not well established. CASE: A 52-year-old female was prescribed warfarin and enoxaparin for a newly diagnosed deep vein thrombosis (DVT) in the left lower extremity. On day 4 of therapy, the patient had a supra-therapeutic international normalized ratio (INR), prompting the discontinuation of enoxaparin and a decrease in the warfarin dose. The patient returned to the emergency department on day 7 of treatment with a purple, cold, and extremely painful right foot with punctate areas of necrosis and petechiae proximal to the discoloration. The patient's INR was found to be 10.64. Following the diagnosis of warfarin-induced skin necrosis, the patient was administered vitamin K intravenously and fresh frozen plasma (FFP) to reverse the effects of warfarin and promote protein C and S synthesis. Once the patient's INR was no longer supratherapeutic, subcutaneous enoxaparin was re-started as treatment for the known recent DVT. The patient's necrotic foot began to improve and she was discharged home with an anticipated full recovery. CONCLUSIONS: Based on the proposed pathophysiology of disease, adequate bridge therapy may decrease the likelihood of developing this life-threatening condition. Early recognition and treatment with intravenous vitamin K, FFP or 4-factor prothrombin complex concentrate, and continued wound care are essential to prevent further complications. äWarfarin-induced skin necrosis (epmc).pdf DeepDyve Pubget Overpricing