病人服用华法林指南
Warfarin (brand names Coumadin and Jantoven) is a prescription medication used to prevent harmful blood clots from forming or growing larger. Beneficial blood clots prevent or stop bleeding, but harmful blood clots can cause a 心脏病, 中风, 深静脉血栓或肺栓塞. 因为华法林会干扰血凝块的形成，所以它被称为an 抗凝剂(PDF). Many people refer to anticoagulants as *blood thinners; however, warfarin does not thin the blood but instead causes the blood to take longer to form a clot.
华法林是如何起作用的?
The formation of a blood clot in the body is a complex process that involves multiple substances called clotting factors. Warfarin decreases the body’s ability to form blood clots by blocking the formation of vitamin K–dependent clotting factors. 维生素K是制造凝血因子和防止出血所必需的. 通过药物阻断凝血因子, 你的身体可以阻止有害血块的形成，防止血块变大.
监测和给药提示
华法林治疗的目的是降低血液的凝血倾向, 不能完全防止凝血. 华法林的作用必须通过血液检测仔细监测. 根据血液测试的结果, your daily dose of warfarin will be adjusted to keep your clotting time within a target range. The blood test used to measure the time it takes for blood to clot is referred to as a prothrombin time test, 或protime (PT). PT以国际标准化比率(INR)报告。.
INR是表示PT值的标准化方式. INR确保不同实验室获得的PT结果可以进行比较. It's important to monitor the INR at least once a month and sometimes as often as twice weekly to make sure the level of warfarin remains in the effective range. 如果印度卢比太低, 血凝块是无法预防的, 但如果印度卢比太高的话, 出血的风险会增加. 这就是为什么服用华法林的人必须频繁验血的原因.
与大多数固定剂量的药物不同, warfarin dosing is adjusted according to the INR blood test results; the dose usually changes over time.
品牌药和仿制药的区别
仿制药应该有相同的剂量, 治疗效果, 给药途径, 副作用和强度与原药相同. 美国.S. Food and Drug Administration requires that all generic drugs be as safe and effective as brand-name drugs.
仿制药通常比品牌药便宜, because the generic manufacturers have not incurred the expenses of developing and marketing a new drug. 在美国, trademark laws do not allow generic drugs to look exactly like the brand-name drug; however, 仿制药必须具有相同的有效成分. 就香豆丁(品牌产品)和华法林(仿制产品)而言, the manufacturers attempted to keep the colors consistent with the strength of the pills. The goal is to allow the patient to identify the color-coded dose and prevent mix-ups or errors. 因此, if the color or dose of the dispensed tablet appears different from the pill taken previously, 患者应立即通知药剂师或卫生保健专业人员.
如果你打算在服用这些药物期间出国旅行, 确保你在逗留期间有足够的食物供应. 如果你需要在美国境外购买这些药物.S., first ask your health care professional to confirm the accuracy and quality of the medication.
华法林必须严格按处方服用.
Never increase or decrease your dose unless told to do so by your health care professional. 如果你错过了一剂，打电话给你的卫生保健办公室寻求建议.
副作用
The major complications associated with warfarin are clotting due to underdosing or bleeding due to excessive anticoagulation. 最严重的出血是胃肠道出血或脑内出血。. 身体的任何部位都可能出血过多, 服用华法林的患者应报告任何跌倒或事故, 以及出血或不寻常瘀伤的体征或症状, 给他们的医疗保健专业人员.
异常出血的症状包括:
- 牙龈出血
- 关节出血
- 尿中带血
- 带血或黑便
- 流鼻血
- 吐血
An unusual headache or a headache that is more severe than usual may signal a brain bleed (hemorrhage).
什么时候打电话给你的医疗保健专业人员
如果你有以下出血迹象, 你应该立即拨打911或你的医疗保健专业人员.
- 严重头痛、神志不清、虚弱或麻木
- 咳出大量鲜红色的血
- 吐血
- 流血不止
- 大便有鲜红色的血
- 头部跌倒或受伤
- 严重的或不寻常的头痛
- 比正常月经出血多
一些简单的改变可以降低服用华法林出血的风险，包括:
- 使用软毛牙刷.
- 使用上蜡的牙线而不是未上蜡的牙线.
- 刮胡子时要用电动剃须刀，不要用刀片.
- 使用刀具、剪刀等尖锐物品时要小心.
- 避免有摔倒或受伤风险的运动和活动.
华法林和生活方式
日常生活的变化会影响印度卢比. 了解华法林治疗常见的注意事项是很重要的.
怀孕
妊娠期间不建议使用华法林. A woman who becomes pregnant or plans to become pregnant while taking warfarin should immediately notify her health care professional.
医疗或牙科程序
It's important to tell all your health care professionals that you are taking warfarin. 如果你正在做手术, 牙科检查或其他医疗程序, 你可能需要停止服用华法林.
旅行
如果你计划旅行，请咨询你的医疗保健专业人员. 旅行时，随身携带药物是很重要的. 不要把它放进托运的包里.
常见的注意事项
| 该怎么做 | 不要做什么 |
| 注意出血的迹象和症状. | 不要因为错过了一剂而加倍服用. |
| 当你生病或受伤时告诉你的医疗保健专业人员. | Don’t start new medications, herbs or supplements without talking to your health care professional. |
| 严格按照医嘱服用华法林. | Don’t make changes to your warfarin dose unless your health care professional tells you to. |
| 告诉任何给你提供医疗或牙科护理的人你正在服用华法林. | |
| 遵守验血的约定. |
华法林与其他药物相互作用
People who take warfarin should consult with their health care professional before taking any new medication, 包括非处方药, 草药和维生素. 许多药物可以改变华法林的有效性, 导致印度卢比过高或过低. 一些最常见的非处方止痛药, 比如布洛芬(品牌名Advil)和萘普生(品牌名Aleve), enhance the anticoagulant effects of warfarin and increase the likelihood of harmful bleeding.
华法林与酒精和某些食物相互作用
- 酒精 酒精会影响人体对华法林的代谢. People on warfarin therapy should avoid drinking alcohol or it should be consumed in moderation. Speak with your health care professional if you are taking warfarin and consume alcohol. 酒精的抗血小板作用会增加大出血的风险, 即使印度卢比保持在目标范围内. 它还可以降低华法林的作用.
- 食物 -有些食物会影响华法林的效力. The most important point to remember is to eat what you normally eat and not to make any major changes in your diet without contacting your health care professional.
- 维生素K -多吃富含维生素K的食物可以降低PT和INR, 降低华法林的疗效，并可能增加血栓的风险. People who take warfarin should eat a relatively similar amount of vitamin K each week. The highest amount of vitamin K is found in green and leafy vegetables such as broccoli, 生菜和菠菜. 没有必要不吃这些食物, 但重要的是要尽量保持你摄入的维生素K的量一致. 下载我们关于维生素K含量高和低的食物的快速参考指南. (PDF)
佩戴医疗标识
长期服用华法林的人应始终佩戴医疗警报手环, 项链或类似的警告标签. 如果发生了事故，而那个人病得无法沟通, 医疗警报标签将帮助急救人员提供适当的护理. The alert should include a list of major medical conditions and the reason warfarin is needed, 以及紧急联系人的姓名和电话号码.
从哪里获得更多信息
Your health care professional is the best source of information for questions and concerns related to your medical problem. 因为没有两个人是完全一样的, 每个人的建议都不一样, it's important to seek guidance from a health care professional who is familiar with your condition.
