se x 2 days5.07.510.012.515.02.0-3.0No change—————3.0-6.0Decrease x 2 days1.252.55.07.510.06.0-10.0?Decrease x 2 days01.252.55.07.510.0-18.0§Decrease x 2 days00002.5>18.0§Discontinue warfarin and consider hospitalization/reversal of anticoagulation?Consider oral vitamin K, 2.5–5 mg§ Oral vitamin K, 2.5–5 mg* Allow 2 days after dosage change for clotting factor equilibration. Repeat prothrombin time 2 days after increasing or decreasing warfarin dosage and use new guide to management (INR = International Normalized Ratio). After increase or decrease of dose for two days, go to new higher (or lower) dosage level (e.g., if 5.0 qd, alternate 5.0/7.5; if alternate 2.5/5.0, increase to 5.0 qd).华法林剂量调节方案传统抗凝药物的作用靶点目前所用抗凝剂的缺点使用方法:需要注射使用治疗谱窄(narrow therapeutic index)药动学和药效学不可预测需要实验室监测出血的风险药物之间的相互作用
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