Adverse warfarin-related events

Tjia J, Field TS, Mazor KM, Donovan JL, Kanaan AO, Reed G, et al. Dementia and risk of adverse warfarin-related events in the nursing home setting. Am J Geriatr Pharmacother 2012 10(5) 323-30. 

Omeprazole is a proton pump inhibitor. Headache, skin rash, and diarrhea have all been recorded by adverse event registries sufficiently often to suggest causal relations (1). Omeprazole is a modest inhibitor of CYP isoforms. Interactions are less likely than with cimetidine and are probably of no practical importance. However, omeprazole reduces the absorption of drugs that require a low gastric pH (ketoconazole, iron salts, ampicilhn) and can inhibit the hepatic clearance of some drugs (diazepam, warfarin, phenytoin) (2). 

Prothrombin complex concentrates In a retrospective chart review of 72 patients who received activated prothrombin complex concentrate factor Vni inhibitor bypassing activity and 69 patients who received fresh-firozen plasma to reverse the effects of warfarin during life-threatening bleeding, the former resulted in lower INR and a shorter time firom drug administration to an INR of 1.4 or less [68. There were no significant differences in survival or in the length of hospital stay. There were five adverse events that could have been related to the prothrombin... 

---