$Unique_ID{BRK01380}
$Pretitle{Blood and Blood Forming Organs}
$Title{Precautions With Coumadin}
$Subject{coumadin bleeding heart attack}
$Volume{D-7}
$Log{}

Copyright (c) 1991   Tribune Media Services, Inc.


Precautions With Coumadin


------------------------------------------------------------------------------

QUESTION:  I take one Coumadin pill a day and my cardiologist has advised me
that at the most, I am allowed only one drink at night.  It suits me fine, but
I am completely puzzled as to the medical logic behind it.  I know that both
substances are metabolized by the liver, but all my liver function tests are
normal and I have no bleeding tendencies.  Please explain the reason for such
advice.  Thank you.

------------------------------------------------------------------------------

ANSWER:  As you probably know already, Coumadin (also known as warfarin
sodium) is used to "thin" the blood, reduce its ability to coagulate or form
clots.  It is used either for the prevention of or the treatment of clots in
the veins (venous thrombosis) and to prevent clots from spreading to all parts
of the body (embolism) after a heart attack (myocardial infarction).  It
obtains its anticoagulant effect by preventing the formation of various
coagulation factors that depend upon Vitamin K for their production.  When the
ability of the blood to coagulate is reduced, clots may not form, or if they
have already formed, they may not grow larger.  When a patient is on this
powerful and effective medication, it is necessary to keep a sharp eye on the
effect of the medication by checking the blood frequently and determining its
ability to coagulate.  Many circumstances can affect that action including
travel, changes in diet, environment, physical state of the patient and a wide
variety of other medications.  The test which is used to control the state of
the bloods ability to coagulate when they are taking Coumadin is called the
"prothrombin" (PTT) test, which is usually performed on a regular basis while
the patient is visiting the physician for a follow up examination.  Among the
many substances that can affect the prothrombin response are antibiotics,
diuretics, thyroid drugs, influenza virus vaccine, and a host of others too
numerous to mention here.  But important among these circumstances (because of
your question) is alcohol.  Both increased and decreased prothrombin time
responses have been reported when alcohol or diuretics are being taken.  That
makes the control of your blood coagulation more difficult, and leaves you
open to the risk of unwanted hemorrhages.  And that is why your cardiologist
has advised that you keep the bottle corked.
ÿ
----------------

The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
