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L09 Anticoagulants - Coggle Diagram

- - - - Increase metabolic clearance of warfarin: Chronic use of alcohol, Carbamazepine, Rifampicin, Griseofulvin, Phenytoin in long term, St John's wort
      - Endogenous factors: Hypothyroidism and Oedema
      - Herbs/OTC: Coenzyme Q10, Ginseng, Danshen, Dong quai, Gingko, Melatonin, Cranberry juice
      - Absorption: Cholestyramine
    - - Phenytoin (initial phase)-> Displace warfarin from protein binding sites
      - Inhibit metabolic clearance of warfarin: Amiodarone, Erythromycin, Metronidazole, Trimethoprim-Sulfamethoxazole, Voriconazole
      - Endogenous factors: Diarrhoea(Decrease GI flora, decrease vit K), Cancer, Fever, Hepatic disorder decrease metabolism of warfarin), Hyperthyroidism, poor nutrition, Vit K deficiency
      - Thyroxine (Increase breakdown of vit K clotting factors)