Warfarin
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• Warfarin (also known under the brand names Coumadin, Jantoven, Marevan, Lawarin, Waran, and Warfant) is an anticoagulant.
• It is most likely to be the drug popularly referred to as a "blood thinner," yet this is a misnomer, since it does not affect the thickness or viscosity of blood. Instead, it acts on the liver to decrease the quantity of a few key proteins in blood that allow blood to clot.
• Warfarin is a synthetic derivative of dicoumarol, a 4-hydroxycoumarin-derived mycotoxin anticoagulant originally discovered in spoiled sweet clover-based animal feeds.
• Warfarin is both odorless and tasteless, and is effective when mixed with food bait, because the rodents will return to the bait and continue to feed over a period of days until a lethal dose is accumulated (considered to be 1 mg/kg/day over about six days).
• It may also be mixed with talc and used as a tracking powder, which accumulates on the animal's skin and fur, and is subsequently consumed during grooming.
• Warfarin is prescribed for patients who are at increased risk for developing harmful blood clots.
• This includes people with a mechanical heart valve, an irregular heart rhythm called atrial fibrillation, and people with certain clotting disorders.
• Excessive bleeding, or hemorrhage, can occur from any area of the body, and patients on warfarin should report any falls or accidents, as well as signs or symptoms of bleeding or unusual bruising.
• Signs of unusual bleeding include bleeding from the gums, blood in the urine, bloody or dark stool, a nosebleed, or vomiting blood.
• Dose adjustments are often necessary and are based on measuring the prothrombin time in blood and calculating an international normalized ratio (INR)
• Warfarin is used to decrease the tendency for thrombosis or as secondary prophylaxis (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 embolism (migration of a thrombus to a spot where it blocks blood supply to a vital organ).
• Warfarin inhibits the vitamin K-dependent synthesis of biologically active forms of the calcium-dependent clotting factors II, VII, IX and X, as well as the regulatory factors protein C, protein S, and protein Z.

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