Clotting disorders: The Daily PANCE Blueprint

Home Clotting disorders: The Daily PANCE Blueprint

Clotting disorders: The Daily PANCE Blueprint

A 72-year-old male with chronic atrial fibrillation managed with warfarin therapy presents to the emergency department with hematemesis. His INR is measured at 4.5. He denies taking any additional doses of warfarin or any new medications. What is the most appropriate immediate intervention to reverse the effects of warfarin?

A. Discontinue warfarin
B. Administer fresh frozen plasma (FFP)
C. Administer vitamin K
D. Administer protamine sulfate
E. Administer prothrombin complex concentrate (PCC)

Answer and topic summary

The answer is E. Administer prothrombin complex concentrate (PCC)

In a patient with a significantly elevated INR and active bleeding due to warfarin therapy, rapid reversal of anticoagulation is necessary. Prothrombin complex concentrate (PCC) is the preferred treatment in this scenario as it provides immediate reversal of the effects of warfarin. PCC contains factors II, VII, IX, and X, which are inhibited by warfarin and work faster than fresh frozen plasma (FFP).

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Hematology ⇒ Coagulation Disorders  ⇒ Clotting factor disorders

Also covered on the Internal Medicine EOR and Emergency Medicine EOR topic lists