Warfarin Hepatotoxicity

Warfarin is an anticoagulant that acts by inhibiting the agitator that recycles vitamin K from its breakable anatomy consistent in alive vitamin K depletion. Warfarin is sometimes advised a vitamin K antagonist, about does so alongside as above. Since vitamin K is adapted for the amalgam of the array factors II, VII, IX, X, protein C and protein S, warfarin inhibits their assembly bearing the anticoagulant effect. Warfarin was initially used as a pesticide adjoin rodents (rat poison).

Liver abrasion due to warfarin analysis is rare, but clinically credible astute alarmist abrasion attributable to it has been reported. Alarmist abrasion is added known with added coumarin derivatives such as phenprocoumon and acenocoumarol, which are accessible in added countries but not in the United States. The archetypal case of astute alarmist abrasion arises aural 3 to 8 weeks of starting warfarin, although attenuate instances of alarmist abrasion arising afterwards months or years of analysis accept been appear (and these continued latencies are known with phenprocoumon hepatotoxicity). The arrangement of alarmist agitator elevations is about cholestatic, but hepatocellular and alloyed patterns accept aswell been reported. Eosinophilia can occur, but added immunoallergic manifestations are not known nor are autoantibodies. Recovery can be prolonged, decidedly with cholestatic injury. Recurrence aloft reexposure has been declared and can be added astringent and aftereffect in death.

Overdose with warfarin can aftereffect in boundless bleeding and hepatic failure. In addition, abiding warfarin analysis has been associated with ad-lib bleeding including hepatic breach and life-threatening intraperitoneal bleeding, even after agony and with INR in the adapted range.