TREATMENT BASED ON INR
1.IF INR = 3.5 to 4.5 with held warfarin
2.IF INR= 4.5 and more , low dose sublingual vitamin k is given until the target is achieved
3.IF INR = 4.9 TO 9 ,,1mg vitamin k is given until the target is achieved
4.IF INR>>9 then 2mg to 3mg vitamin k is given until the target is achieved
5.if severe bleeding ---vit k 10mg slow iv plus additional vit k until target is reached,also fresh
frozen plasma can be supplemented to vit k.If there is volume overload prothrombin complex
concentrates cane given
6.in case of patients(on warfarin) posted for surgery ,the drug should be stopped 5 days before sx.
(in such cases if INR <2 and high risk of thromboembolism, then LMWH given once or twice daily
and stopped 12-24hrs before surgery)