It is 29/03/2016. You are an FY1 on call and have been asked to prescribe warfarin for a patient on ward 5. Ian Dwelling-Catheter, (Hospital Number MS4345632, Date of Birth 22/4/1951) is a gentleman who had been admitted to hospital following an unresponsive episode. Since admission it has been noted that he is in Atrial Fibrillation. This had not been previously documented on previous admissions. On reviewing the old medical notes, you see that he had a hip operation last year and unfortunately experienced a DVT during recovery. He also sees her doctor regularly due to high blood pressure. His current medications include Atorvastatin, Ramipril and Furosemide.
Ian has read about the beneficial effects of anticoagulation, and wishes to commence on warfarin. After consideration and discussion, this becomes part of the ongoing management plan.
His INR has been measured since this decision has been made:
24/03/2016 INR – not measured
25/03/2016 INR – not measured
26/03/2016 INR – 1.4
27/03/2016 INR – 1.7
28/03/2016 INR – 1.8
29/03/2016 INR – 2.1
Using these readings and the Warfarin algorithm, please fill in the Warfarin chart below and prescribe his next dose accordingly.
