نکاتی را که باید در مصرف وارفارین رعایت کرد

هدف از درمان با عوامل ضد انعقادي چون وارفارين ( كومادين) كاهش و پيشگيري از تشكيل لخته خون است. مهمترين جنبه درماني وارفارين حفظ سطح درماني دارو در خون است

.اگر سطح دارو در خون خيلي پائين باشد احتمال تشکيل لخته خون وجود دارد و چنانچه سطح دارو بالا باشد احتمال خونريزي وجود دارددرمان موثر و مطمئن در گرو داشتن دانش درباره درمان با وارفارين و عوامل موثر بر درمان ميباشد.راهنماي دارويي ارائه شده جهت پاسخ به سوالات شما درباره درمان با وارفارين تهيه شده استوارفارين چيست؟

قرص وارفارين داروي ضد تشکيل لخته است که توانايي بدن براي تشکيل لخته خون را کاهش ميدهد

هدف پزشک شما از تجويز وارفارين جلوگيري از تشکيل لخته اي است که بدن شما به آن نياز ندارد. از جمله موارد استفاده از وارفارين ميتوان به ريتم نامنظم قلب، آمبولي ريه،بيماريهاي دريچه اي قلب و دريچه مصنوعي و تشکيل لخته در عروق عمقي اشاره کردوارفارين چگونه کنترل ميشود؟

INR ۳-۲ در اکثر موارد معرف سطح درماني وارفارين است که اين ميزان ممکن است با توجه شرايط بيماري شما و نظر پزشک شما متفاوت باشد. INR کمتر از ۱.۵ نشان ميدهد که خون شما خيلي غليظ است و شما ممکن است در معرض تشکيل لخته قرار بگيريد. در اين حالت پزشک معالج شما مقدار دارو را افزايش ميدهد. در موارد INR بالاتر از درماني مثلا ۴.۵ خون شما خيلي رقيق است و ممکن است خطر خونريزي وجود داشته باشد که پزشک معالج شما مقدار دارو را کم ميکند.

درکساني که وارفارين را تازه شروع ميکنند INR ممکن است سطح متغيري داشته باشد از اينرو کنترل مکرر سطح INR تا رسيدن آن به سطحي ثابت لازم استوارفارين را در چه زمان مصرف کنم؟

مهمترين نکته در باره مصرف قرص وارفارين ، خوردن دارو در وقت معين است بطوريکه فراموش نشود

زمان ايده ال مصرف دارو ” عصر ” است

با توجه به اينکه غذا ممکن است بر جذب دارو تاثير بگذارد ، دارو نيم ساعت قبل يا يکساعت بعد از غذا مصرف شود

وارفارين را تا چه زماني مصرف کنم؟

 بسته به نظر پزشک معالج شما و بر اساس نوع بيماري شما ، ممکن است درمان موقت يا براي تمام عمر باشد.

به هنگام مسافرت چه اقداماتي لازم است؟

 پزشک شما ميزان دارو را تنظيم ميکند ولي سعي کنيد رژيم غذايي ثابت داشته باشيد

اگر جراحي، درمان دندانپزشکي يا ساير اقدامات تهاجمي مثل آنژيوگرافي داشته باشم چه اتفاقي مي افتد؟

بر اساس نوع کار درماني شما ، وارفارين با نظر پزشک معالج شما موقتا قطع ميشود.و ممکن است درمان جايگزين با دارو هاي ضد انعقادي ديگر شروع شود. از اينرو قبل از هر اقدامي پزشک خود را مطلع کنيد.چرا که ممکن است در خطر خونريزي قرار گيريد.

 آيا رژيم غذايي با مصرف وارفارين تداخل دارد؟

 وارفارين با ويتامين K رژيم غذايي شما تداخل دارد

منابع غذايي ويتامين K برگ سبزيجات سبز تيره چون بروکلي، اسفناج، کاهو و کلم سبز است. نکته مهم مصرف هفتگي يکنواخت اين سبزيجات است نه حذف کامل اين ترکيبات از رژيم غذايي.

وارفارين با چه داروهايي تداخل دارد؟

برخي آنتي بيوتيک ها، مسکن ها ، داروهاي ضد التهابي ، داروهاي ضد صرع، ضد افسردگي، ضد پلاکت، ضد ديابت ،ضد چربي، ضد نقرس، داروهاي گوارشي، داروهاي ضد قارچ و نيز داروهاي گياهي نظير جوز هندي ممکن است سبب بالا رفتن يا پائين آمدن بيش از حد INR شوند. نکته مهم مصرف اين دارو ها زير نظر پزشک معالج است

عوارض احتمالي

خونريزي از بيني ، لثه هنگام مسواک زدن، استفراغ خوني، خون در ادرار، مدفوع قرمز يا تيره ، کبودي غير طبيعي ، قطع نشدن خونريزي در بريدگي ها ، افزايش خون قاعدگي، سردرد گيجي و ضعف ، درد و التهاب غير طبيعي، ريزش مو و بثورات پوستي

 اگر دارو را فراموش کرديد خودسرانه مقدار دارو را زياد نکنيد

مکمل هاي غذايي و داروهاي ديگر را بدون مشورت با پزشک خود تغيير ندهيد، شروع نکنيد و قطع نکنيدتغييرات واضح و زياد در رژيم غذايي خود ندهيدورزش هايي که تماسي است و احتمال آسيب رساني دارد انجام  ندهید در حين بارداري از مصرف وارفارين بپرهيزيد

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