What exactly is warfarin?


What exactly is warfarin?

            Warfarin (also known under the brand names CoumadinJantoven
MarevanLawarinWaran, and Warfant) is an anticoagulant normally used
 in the prevention of the formation of blood clots in the blood vessels and their migration
 elsewhere in the body respectively. 

            It was initially introduced in 1948 as a pesticide against rats and mice

             In the early 1950s warfarin was found to be effective and relatively safe for 
preventing abnormal formation and migration of blood clots in many disorders
 (such formations may lead to heart attacks or strokes). It was approved for use as a
 medication in 1954 and has remained popular ever since; warfarin is the most widely
 prescribed oral anticoagulant drug in North America.

            Despite its effectiveness, treatment with warfarin has several shortcomings. 
Many commonly used medications interact with warfarin, as do some foods (particularly 
leaf vegetable foods or "greens," since these typically contain large amounts of vitamin K
and its activity has to be monitored by blood testing for the international normalized ratio 
(INR) to ensure an adequate yet safe dose is taken. 

             A high INR predisposes to a high risk of bleeding, while an INR below the therapeutic
 target indicates that the dose of warfarin is insufficient to protect against abnormal 
formation and migration of blood clots. 

             Warfarin is used to decrease the tendency for thrombosis or for prevention of
 further episodes in those individuals that have already formed a blood clot (thrombus). 
Warfarin treatment can help prevent formation of future blood clots and help reduce the 
risk of migration of a thrombus to a spot where it blocks blood supply to a vital organ.

            Warfarin is best suited for anticoagulation (clot formation inhibition) in areas of 
slowly running blood (such as in veins and the pooled blood behind artificial and natural 
valves) and in blood pooled in dysfunctional cardiac atria. 

Thus, common clinical indications for warfarin use are atrial fibrillation, the presence of 
artificial heart valves, deep venous thrombosis, and pulmonary embolism (where the 
embolized clots first form in veins). Warfarin is also used in antiphospholipid syndrome. 
It has been used occasionally after heart attacks (myocardial infarctions), but is far less 
effective at preventing new thromboses in coronary arteries. Prevention of clotting in 
arteries is usually undertaken with antiplatelet drugs, which act by a different mechanism f
rom warfarin (which normally has no effect on platelet function).

(the above was taken from Wikipedia at http://en.wikipedia.org/wiki/Warfarin). 
The items above in italics and the underlined emphasis, I have added)

Just for interest, the molecule of warfarin is shown below!
The name warfarin stems from its discovery at the University of Wisconsin
incorporating the acronym for the organization which funded the key research 
(WARF, for Wisconsin Alumni Research Foundation).

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