It is 29/03/2016. You are an FY1 on call and have been asked to prescribe warfarin for a patient on ward 1. Laura Zepam (Hospital Number MS287453, date of birth 03/08/1944) is a lady who had been admitted to hospital following a GP referral for increasing shortness of breath. She had an irregularly irregular pulse on admission and ECGs confirmed atrial fibrillation. She is known to be in heart failure, and her symptoms have been getting increasingly worse. Her current medications include Atorvastatin, Ramipril, Furosemide, Spironolactone and Bisoprolol.
It is decided that she is at high risk of stroke, and she is subsequently to begin warfarin treatment to reduce this risk.
Her 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 – 2.9
27/03/2016 INR – 2.8
28/03/2016 INR – 3.1
29/03/2016 INR – 2.8
Using these readings and the Warfarin algorithm, please fill in the Warfarin chart below and prescribe her next dose accordingly.
