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Warfarin Toxicity and Individual Variability—Clinical Case

Warfarin is a widely used anticoagulant in the treatment and prevention of thrombosis, in the treatment for chronic atrial fibrillation, mechanical valves, pulmonary embolism, and dilated cardiomyopathy. It is tasteless and colorless, was used as a poison, and is still marketed as a pesticide agains...

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Autores principales: Piatkov, Irina, Rochester, Colin, Jones, Trudi, Boyages, Steven
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153177/
https://www.ncbi.nlm.nih.gov/pubmed/22069565
http://dx.doi.org/10.3390/toxins2112584
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author Piatkov, Irina
Rochester, Colin
Jones, Trudi
Boyages, Steven
author_facet Piatkov, Irina
Rochester, Colin
Jones, Trudi
Boyages, Steven
author_sort Piatkov, Irina
collection PubMed
description Warfarin is a widely used anticoagulant in the treatment and prevention of thrombosis, in the treatment for chronic atrial fibrillation, mechanical valves, pulmonary embolism, and dilated cardiomyopathy. It is tasteless and colorless, was used as a poison, and is still marketed as a pesticide against rats and mice. Several long-acting warfarin derivatives—superwarfarin anticoagulants—such as brodifacoum, diphenadione, chlorophacinone, bromadiolone, are used as pesticides and can produce profound and prolonged anticoagulation. Several factors increase the risk of warfarin toxicity. However, polymorphisms in cytochrome P450 genes and drug interactions account for most of the risk for toxicity complications. Each person is unique in their degree of susceptibility to toxic agents. The toxicity interpretation and the health risk of most toxic substances are a subject of uncertainty. Genetically determined low metabolic capacity in an individual can dramatically alter the toxin and metabolite levels from those normally expected, which is crucial for drugs with a narrow therapeutic index, like warfarin. Personalized approaches in interpretation have the potential to remove some of the scientific uncertainties in toxicity cases.
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spelling pubmed-31531772011-11-08 Warfarin Toxicity and Individual Variability—Clinical Case Piatkov, Irina Rochester, Colin Jones, Trudi Boyages, Steven Toxins (Basel) Article Warfarin is a widely used anticoagulant in the treatment and prevention of thrombosis, in the treatment for chronic atrial fibrillation, mechanical valves, pulmonary embolism, and dilated cardiomyopathy. It is tasteless and colorless, was used as a poison, and is still marketed as a pesticide against rats and mice. Several long-acting warfarin derivatives—superwarfarin anticoagulants—such as brodifacoum, diphenadione, chlorophacinone, bromadiolone, are used as pesticides and can produce profound and prolonged anticoagulation. Several factors increase the risk of warfarin toxicity. However, polymorphisms in cytochrome P450 genes and drug interactions account for most of the risk for toxicity complications. Each person is unique in their degree of susceptibility to toxic agents. The toxicity interpretation and the health risk of most toxic substances are a subject of uncertainty. Genetically determined low metabolic capacity in an individual can dramatically alter the toxin and metabolite levels from those normally expected, which is crucial for drugs with a narrow therapeutic index, like warfarin. Personalized approaches in interpretation have the potential to remove some of the scientific uncertainties in toxicity cases. MDPI 2010-10-28 /pmc/articles/PMC3153177/ /pubmed/22069565 http://dx.doi.org/10.3390/toxins2112584 Text en © 2010 by the authors; licensee MDPI, Basel, Switzerland http://creativecommons.org/licenses/by/3.0/ This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).
spellingShingle Article
Piatkov, Irina
Rochester, Colin
Jones, Trudi
Boyages, Steven
Warfarin Toxicity and Individual Variability—Clinical Case
title Warfarin Toxicity and Individual Variability—Clinical Case
title_full Warfarin Toxicity and Individual Variability—Clinical Case
title_fullStr Warfarin Toxicity and Individual Variability—Clinical Case
title_full_unstemmed Warfarin Toxicity and Individual Variability—Clinical Case
title_short Warfarin Toxicity and Individual Variability—Clinical Case
title_sort warfarin toxicity and individual variability—clinical case
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153177/
https://www.ncbi.nlm.nih.gov/pubmed/22069565
http://dx.doi.org/10.3390/toxins2112584
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