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Old 07-13-2012
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Help Heparin and Warfarin Confusion!

Is everyone in this forum encountering a confusion when struggling through the hematology regarding which one to choose between heparin and warfarin to achieve the anticoagulant stage in the treatment of thrombosis or prophylaxis to heart valve replacement?
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Old 07-13-2012
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How I understand that heparin is usually given from the beginning bse it starts working immediately . In contrast, for warfarin needs to have some time for the developing its effect ( when all previously syntes-d vit K become depleted and new one will be not able to form bse of inhibition the epoxide reductase)
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Old 07-14-2012
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Quote:
Originally Posted by eveli55 View Post
How I understand that heparin is usually given from the beginning bse it starts working immediately . In contrast, for warfarin needs to have some time for the developing its effect ( when all previously syntes-d vit K become depleted and new one will be not able to form bse of inhibition the epoxide reductase)
yes and heparin is given in the beginning and its given IW or subcut(LMWH) so u cant prescribe it to patients on discgarge. Warfarin instead is taken orally so it can be taken at home. Both need extensive monitoring with PT(warfarin) and PTT(heparin) frequently. But LMWH, i believe, dosnt need frequent monitoring.
But if the patient is pregnant, remember u can neveg give warfarin because it is lipid soluble and easily crosses the placenta and is teratogenic!! For pregnants its always heparin.

Hope that helped
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Old 07-14-2012
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Originally Posted by belindalimm View Post
Is everyone in this forum encountering a confusion when struggling through the hematology regarding which one to choose between heparin and warfarin to achieve the anticoagulant stage in the treatment of thrombosis or prophylaxis to heart valve replacement?
warfarin is oral tabs with long half life hence its used in long term prophylaxis in out pxt setting while heparin is has short half life,given parenteral and used in acute setting and must be used in hospital setting.

so your option should be based on the clinical vignette.
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Old 07-14-2012
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So Wafarin starts with "W" and its oral so, its "WOW Its Yummy" and stays for long in your GI system, means long half life.

Heparin Starts with "H" and its Parenteral , So " I Hate IV "...And it has to circle in the blood which is fast , means Short Half life.

Funny but hopefully effective way of remembering it.lolz
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Old 07-15-2012
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Quote:
Originally Posted by eveli55 View Post
How I understand that heparin is usually given from the beginning bse it starts working immediately . In contrast, for warfarin needs to have some time for the developing its effect ( when all previously syntes-d vit K become depleted and new one will be not able to form bse of inhibition the epoxide reductase)
Yes! i totally agree... very simply speaking first give some Low Molecular Weight Heparin and then after that continue on warfarin.. Warfarin is somewhat like prophylaxis treatment.
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Old 07-15-2012
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Originally Posted by belindalimm View Post
Is everyone in this forum encountering a confusion when struggling through the hematology regarding which one to choose between heparin and warfarin to achieve the anticoagulant stage in the treatment of thrombosis or prophylaxis to heart valve replacement?
Also, warfarin decrease synthesis protein C and S and in the begining therapy with warfarin patiet will have hypercoagulable state . Prevent this condition help heparin.
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