{"id":8664,"date":"2025-06-25T16:28:48","date_gmt":"2025-06-25T13:28:48","guid":{"rendered":"https:\/\/drhasankasap.com\/?p=8664"},"modified":"2025-09-10T22:37:43","modified_gmt":"2025-09-10T19:37:43","slug":"warfmadin-kullanim-kilavuzu-2","status":"publish","type":"post","link":"https:\/\/drhasankasap.com\/index.php\/2025\/06\/25\/warfmadin-kullanim-kilavuzu-2\/","title":{"rendered":"Warfmadin Kullan\u0131m K\u0131lavuzu"},"content":{"rendered":"\t\t
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\u00a0<\/h5>

WARFMAD\u0130N Kullan\u0131m K\u0131lavuzu<\/span><\/h1>

\u00a0<\/h3>

Warfarin Nedir ?<\/strong><\/span><\/h4>
\u00a0<\/strong><\/span><\/div>

Halk aras\u0131nda \u201ckan suland\u0131r\u0131c\u0131\u201d olarak bilinen ila\u00e7lardan bir tanesidir. Asl\u0131nda kan\u0131 suland\u0131rmaz, sululu\u011funu art\u0131rmaz, olu\u015fan p\u0131ht\u0131y\u0131 eritmez. Sadece p\u0131ht\u0131la\u015fmay\u0131 ve olu\u015fan p\u0131ht\u0131n\u0131n b\u00fcy\u00fcmesini engeller. Biz t\u0131p dilinde bu ila\u00e7lar\u0131 \u201canti-koag\u00fclan\u201d olarak adland\u0131r\u0131yoruz. T\u00fcrk\u00e7e tam kar\u015f\u0131l\u0131\u011f\u0131 olarak; \u201cp\u0131ht\u0131 \u00f6nler ila\u00e7\u201d<\/strong> demek daha do\u011fru olacakt\u0131r. Ancak hastalar\u0131m\u0131z\u0131n diline bu ila\u00e7 \u201ckan suland\u0131r\u0131c\u0131\u201d olarak yerle\u015fti\u011fi i\u00e7in ben de bu makalede, anla\u015f\u0131lmay\u0131 kolayla\u015ft\u0131rmak i\u00e7in zaman zaman \u201ckan suland\u0131r\u0131c\u0131\u201d ifadesini kullanmay\u0131 tercih edece\u011fim.<\/span><\/p>

\u00a0<\/span><\/p>

\"\"<\/p>

Beyne p\u0131ht\u0131 atmas\u0131 (inme, fel\u00e7), bacak damarlar\u0131nda p\u0131ht\u0131 olu\u015fmas\u0131 (Derin Ven Trombozu), akci\u011fere p\u0131ht\u0131 atmas\u0131 (Pulmoner Emboli) gibi hastal\u0131klar\u0131n tedavisi ve tekrarlar\u0131n\u0131n engellenmesinde, kalp ritm bozukluklar\u0131nda (Atriyal Fibrilasyon=AF) kalbin i\u00e7inde olu\u015fabilecek p\u0131ht\u0131lar\u0131n \u00a0engellenmesinde, metalik kalp kapak protezine sahip hastalarda kapaklar\u0131n \u00fczerinde p\u0131ht\u0131 olu\u015fumunun engellenmesinde on y\u0131llard\u0131r kullan\u0131lmaktad\u0131r.<\/span><\/p>

\u00a0<\/span><\/p>

\u0130la\u00e7 1954\u2019ten beri COUMAD\u0130N markas\u0131yla bilinmektedir. Yak\u0131n zamana kadar \u00fclkemizde de bu ad ile bilinmekte iken, art\u0131k sadece WARFMAD\u0130N marka ad\u0131yla eczanelerde yer almaktad\u0131r. Hastalar\u0131m\u0131z art\u0131k bu ad ile tan\u0131d\u0131klar\u0131 i\u00e7in, ben de makalenin geri kalan\u0131nda etken madde olan \u201cwarfarin\u201d yerine s\u0131kl\u0131kla piyasa ad\u0131 olan \u201cWarfmadin\u201d ad\u0131n\u0131 kullanaca\u011f\u0131m.<\/span><\/p>

\u00a0<\/span><\/p>

Kardiyolojide kulland\u0131\u011f\u0131m\u0131z bir \u00e7ok ilaca de\u011fil de Warfmadin\u2019e \u00f6zel bir makale yazmam\u0131z\u0131n nedenine gelince\u2026<\/span><\/p>

\u00a0<\/span><\/p>

Son y\u0131llarda yeni p\u0131ht\u0131 \u00f6nler ila\u00e7lar\u0131n kullan\u0131ma girmesi ile kullan\u0131m alan\u0131 daralsa da, \u201cmekanik kalp kapak protezi\u201d olanlarda, orta-ileri derece romatizmal mitral kapak darl\u0131\u011f\u0131 olan ritim bozuklu\u011fu (AF) hastalar\u0131nda ve ileri seviye b\u00f6brek yetersizli\u011fi olup di\u011fer p\u0131ht\u0131 engelleyici ila\u00e7lar\u0131 kullanmalar\u0131 sak\u0131ncal\u0131 olan hastalarda bug\u00fcn i\u00e7in h\u00e2l\u00e2 alternatifsiz tek ila\u00e7t\u0131r. B\u00f6yle \u00f6nemli, hayat kurtaran ve ya\u015fam kalitesini koruyan bir ila\u00e7 olmas\u0131na ra\u011fmen, ba\u015far\u0131yla kullan\u0131lmas\u0131, istenen etkinin tam olarak sa\u011flanabilmesi ve yan etkilerinden ka\u00e7\u0131n\u0131lmas\u0131 \u00e7o\u011fu zaman kolay de\u011fildir. \u00c7\u00fcnk\u00fc ilac\u0131n kimde hangi dozda yeterli etkiyi sa\u011flayaca\u011f\u0131, hangi dozda yan etkilerin \u00f6zellikle de kanamalar\u0131n olu\u015fabilece\u011fi \u00f6nceden bilinemez. \u0130lac\u0131n yeterli etkinli\u011fi olu\u015ftu\u011funda, ayn\u0131 dozda kullan\u0131lmaya devam edilse bile zamanla e\u015flik eden hastal\u0131klar, enfeksiyonlar, kullan\u0131lan ila\u00e7lar,\u00a0 beslenme al\u0131\u015fkanl\u0131klar\u0131ndaki de\u011fi\u015fiklikler gibi etkenler, ilac\u0131n p\u0131ht\u0131 \u00f6nleyici etkisini de\u011fi\u015ftirebilir. Bu nedenle sabit ve devaml\u0131 olarak gereken etkiyi sa\u011flamak ve p\u0131ht\u0131 olu\u015fumu ile ya\u015fanabilecek ciddi hastal\u0131klar\u0131 engelleyebilmek i\u00e7in, ilac\u0131n kullan\u0131m kurallar\u0131na mutlaka uymak gerekir. Bu kullan\u0131m kurallar\u0131na uyulmad\u0131\u011f\u0131nda, hayat kurtarmak ve ya\u015fam kalitesini korumak i\u00e7in kulland\u0131\u011f\u0131m\u0131z bu ila\u00e7, ya\u015fam\u0131m\u0131z\u0131 ve ya\u015fam kalitemizi bizzat kendisi tehdit etmeye ba\u015flar.<\/span><\/p>

\u00a0<\/span><\/p>

\u0130\u015fte bu nedenle bu ilaca \u00f6zel bir makale yazmak ve \u00a0Warfmadin kullanmak zorunda olanlara, do\u011fru ve g\u00fcvenli kullan\u0131m\u0131n kurallar\u0131ndan bahsetmek istedim. Uzunca olacak ama,\u00a0 bu yaz\u0131 herkesin okumas\u0131 i\u00e7in de\u011fil zaten\u2026 Sadece kendisi ya da bak\u0131m\u0131n\u0131 \u00fcstlendi\u011fi bir yak\u0131n\u0131\u00a0 Warfmadin kullanan ki\u015filer i\u00e7in yaz\u0131lm\u0131\u015ft\u0131r. \u0130\u015fte bu muhataplar\u0131n sonuna kadar okumas\u0131n\u0131, zaman zaman tekrar gelip okumas\u0131n\u0131 tavsiye ederim.<\/span><\/p>

\u00a0<\/span><\/p>

S\u00f6z\u00fcn buras\u0131nda toksikolojinin babas\u0131 say\u0131lan Paraselsus<\/a>\u2019un (1493\u00a0\u2013\u00a01541<\/a>) \u00a0\u015fu s\u00f6z\u00fcn\u00fc hat\u0131rlatmam gerekiyor:\u00a0 <\/span>\u201cB\u00fct\u00fcn maddeler (ila\u00e7lar) zehirdir. \u0130la\u00e7 ile zehiri ay\u0131ran; dozudur\u201d<\/strong><\/span><\/p>

\u00a0<\/strong><\/span><\/p>

Neden Warfmadin hakk\u0131nda konu\u015furken, i\u00e7inde \u201czehir\u201d ge\u00e7en bu s\u00f6z\u00fc \u00f6zellikle hat\u0131rlatmak istedim; \u00a0buyrun ve ilac\u0131n tarihine bakal\u0131m\u2026 Anlayacaks\u0131n\u0131z\u2026<\/span><\/p>

\u00a0<\/h3>

Warfarin\u2019in K\u0131sa Tarih\u00e7esi<\/strong><\/span><\/h4>
\u00a0<\/strong><\/span><\/div>

\"\"<\/a><\/span><\/p>

1920\u2019li y\u0131llar\u0131n ba\u015flar\u0131nda Kuzey Amerika\u2019da ve Kanada\u2019da bir tatl\u0131\u00a0yonca \u00a0\u00e7e\u015fidinin k\u00fcflenmi\u015f halini yiyen s\u0131\u011f\u0131rlarda kanamalar\u0131n olu\u015ftu\u011fu g\u00f6zlemlenmi\u015f.\u00a01939\u2019da Wisconsin \u00dcniversitesinde bir kimyager olan Dr. Karl Paul Link, hayvanlarda kanamaya neden olan bu molek\u00fcl\u00fcn, tar\u00e7\u0131n gibi bitkilerde bulunan ve \u00f6zellikle tatl\u0131 yoncada bol miktarda bulunan kumarin\u2019in, k\u00fcflenme sonucunda d\u00f6n\u00fc\u015ft\u00fc\u011f\u00fc bir molek\u00fcl oldu\u011funu ke\u015ffetti ve bu molek\u00fcle \u201cdikumarol\u201d ad\u0131n\u0131 verdi.<\/span><\/p>

\u00a0<\/span><\/p>

Bu molek\u00fcl\u00fcn kan\u0131n p\u0131ht\u0131la\u015fmas\u0131n\u0131 engelleyerek kanamaya sebep oldu\u011fu anla\u015f\u0131ld\u0131\u011f\u0131ndan, bir yandan \u201cinsanlarda p\u0131ht\u0131la\u015fma sebebiyle olu\u015fan hastal\u0131klarda kullan\u0131labilir miyiz?\u201d diye, di\u011fer taraftan da o y\u0131llar\u0131n \u00f6nemli problemi olan \u201cfarelerle m\u00fccadelede kullanabilir miyiz?\u201d diye ara\u015ft\u0131rmalar yap\u0131lmaya ba\u015flanm\u0131\u015f. \u0130kinci hedefe daha erken ula\u015f\u0131lm\u0131\u015f.<\/span><\/p>

\u00a0<\/span><\/p>

\"\"\"\"<\/a>Dr. Link laboratuvar\u0131nda, dikumarol\u2019\u00fcn fareleri daha kuvvetli \u00f6ld\u00fcrebilecek de\u011fi\u015fik bir formunu (varyant\u0131n\u0131) \u00fcretti. Bu \u00fcretim ara\u015ft\u0131rmalar\u0131na sponsor olan WARF (Wisconsin Alumanuae Resarch Foundation) vakf\u0131n\u0131n ismi \"\"<\/a>ve \u201ckumarin\u201d kelimesinin son d\u00f6rt harfi birle\u015ftirerek bu yeni molek\u00fcle \u201cWARFAR\u0130N\u201d ad\u0131n\u0131 verdi. Ard\u0131ndan 1950 y\u0131l\u0131nda ilk kez bir fare zehri olarak \u201cd-CON\u201d marka ad\u0131yla piyasaya s\u00fcr\u00fcld\u00fc. O y\u0131llardan bug\u00fcne kadar warfarin h\u00e2l\u00e2 fare zehiri olarak kullan\u0131lmakta ve fareleri kanatarak \u00f6ld\u00fcrmektedir.\u00a0 Resimde g\u00f6r\u00fclen fare zehrini (Racumin) ya\u015f\u0131 40\u2019\u0131n \u00fczerinde olanlar ve \u00f6zellikle Anadolu\u2019da ya\u015fayanlar daha iyi hat\u0131rlayacaklard\u0131r\u2026<\/span><\/p>

\u00a0<\/span><\/p>

1951 y\u0131l\u0131nda, intihar amac\u0131yla warfarin i\u00e7en bir askerin, dikumarol\u00fcn panzehiri oldu\u011fu bilinen K vitamini ile tedavi edilebilmesi, fare zehri olarak piyasada bulunan ilac\u0131n insanlarda da kullan\u0131labilmesinin \u00f6n\u00fcn\u00fc a\u00e7t\u0131. \u00c7\u00fcnk\u00fc kalp krizi ve fel\u00e7lerin kan\u0131n damar i\u00e7inde p\u0131ht\u0131la\u015fmas\u0131 sonucu geli\u015fti\u011fi biliniyordu. P\u0131ht\u0131la\u015fmay\u0131 zorla\u015ft\u0131ran bir ila\u00e7 bu hastal\u0131klara ba\u011fl\u0131 \u00f6l\u00fcm ve sakatl\u0131\u011f\u0131 \u00f6nleyebilirse \u00e7ok faydal\u0131 olabilirdi. Nihayetinde 1954 y\u0131l\u0131nda warfarin insanlarda t\u0131bbi kullan\u0131m i\u00e7in onay ald\u0131 ve COUMAD\u0130N ticari ismi ile piyasaya \u00e7\u0131kt\u0131. Amerikan ba\u015fkan\u0131 Eisenhover\u2019\u0131n 1955 y\u0131l\u0131nda kalp krizi ge\u00e7irdikten sonra Coumadin ile tedavi edilmesi ilac\u0131n bilinirli\u011fini ve yayg\u0131n kullan\u0131m\u0131n\u0131 art\u0131rd\u0131. B\u00f6ylece ba\u015flang\u0131\u00e7ta fare zehiri olarak kullan\u0131lan bir molek\u00fcl 70 y\u0131ld\u0131r hayat kurtarmakta olan bir ilaca d\u00f6n\u00fc\u015ft\u00fc.\u00a0<\/span><\/p>

\u00a0<\/span><\/p>

Paraselsus\u2019un yukardaki s\u00f6z\u00fcnden yola \u00e7\u0131karak diyebiliriz ki; asl\u0131nda t\u00fcm ila\u00e7lar i\u00e7in ge\u00e7erli olan \u201cuygun doz\/dozun ayarlanmas\u0131\u201d kural\u0131, Warfarin i\u00e7in daha \u00f6nemli ve daha vazge\u00e7ilmezdir. Yaz\u0131n\u0131n devam\u0131nda Warfarin\u2019i daha yak\u0131ndan tan\u0131yaca\u011f\u0131z ve kullan\u0131m kurallar\u0131n\u0131 \u00f6\u011frenece\u011fiz. Sab\u0131rla okumaya devam edelim. Hele siz ya da bak\u0131m\u0131n\u0131 \u00fcstlendi\u011finiz bir yak\u0131n\u0131n\u0131z bu ilac\u0131 kullan\u0131yorsan\u0131z, l\u00fctfen sonuna kadar okuyunuz.<\/strong><\/span><\/p>

\u00a0<\/strong><\/span><\/p>

\u00a0<\/strong><\/span><\/p>

WARFMAD\u0130N Nas\u0131l Etkili Olur?<\/strong><\/span><\/h4>
\u00a0<\/strong><\/span><\/div>

Gelin futbol diliyle konu\u015fal\u0131m yine\u2026 Kan\u0131m\u0131zda birbirine rakip olarak yar\u0131\u015fan iki futbol tak\u0131m\u0131 (sistem) vard\u0131r. Birisi; kan\u0131 s\u00fcrekli ak\u0131\u015fkan tutan ve damar i\u00e7inde p\u0131ht\u0131la\u015fmay\u0131 engelleyen tak\u0131m; bu tak\u0131m\u0131n ad\u0131 \u201csuland\u0131r\u0131c\u0131lar\u201d olsun. Di\u011feri; kan\u0131 p\u0131ht\u0131la\u015ft\u0131rmakla g\u00f6revli, olas\u0131 bir kanamada p\u0131ht\u0131 olu\u015fturarak kanamay\u0131 durduracak tak\u0131m; bu tak\u0131m\u0131n da ad\u0131 \u201cp\u0131ht\u0131c\u0131lar\u201d olsun. Bu iki tak\u0131m\u0131n oyuncular\u0131 kanda belirli bir denge halinde bulunurlar. Bu denge bir yandan kan\u0131n ak\u0131\u015fkanl\u0131\u011f\u0131 sa\u011flarken di\u011fer yandan bir kanama durumunda gecikmeden p\u0131ht\u0131la\u015fmay\u0131 sa\u011flayarak kanamay\u0131 durdurur.<\/span><\/p>

\u00a0<\/span><\/p>

Kalp ya da damar i\u00e7inde kan\u0131n kolayca p\u0131ht\u0131la\u015fmas\u0131na sebep olabilecek bir durum varsa; \u201cp\u0131ht\u0131c\u0131lar tak\u0131m\u0131n\u0131n\u201d g\u00fcc\u00fcn\u00fc azaltacak ila\u00e7lar vererek, p\u0131ht\u0131 olu\u015fumunu engelleyebiliriz. Tabiri caizse; denge halinde olan iki tak\u0131mdan, \u201csuland\u0131r\u0131c\u0131lar tak\u0131m\u0131\u201d lehine olacak \u015fekilde, \u201cp\u0131ht\u0131c\u0131lar tak\u0131m\u0131na\u201d \u00e7elme takar\u0131z. \u00a0\u0130\u015fte bu \u00e7elmeyi \u201cWarfmadin\u201d ile takar\u0131z. Suland\u0131r\u0131c\u0131lar tak\u0131m\u0131n\u0131n az farkla galip gelmesini sa\u011flayarak p\u0131ht\u0131 olu\u015fumunu engelleriz.<\/span><\/p>

\u00a0<\/span><\/p>

P\u0131ht\u0131c\u0131lar \u00a0tak\u0131m\u0131n\u0131n y\u0131ld\u0131z oyuncular\u0131n\u0131n (Fakt\u00f6r II, VII, IX ve X, Protein C,S) ma\u00e7a \u00e7\u0131kabilmeleri (karaci\u011ferde \u00fcretilebilmeleri) i\u00e7in K-Vitaminine ihtiya\u00e7lar\u0131 vard\u0131r. Bu vitaminin etki etmesini engelledi\u011fimizde, y\u0131ld\u0131z oyuncular ma\u00e7a \u00e7\u0131kamaz, \u201cp\u0131ht\u0131c\u0131lar tak\u0131m\u0131\u201d ma\u011flup olur ve p\u0131ht\u0131 olu\u015fmas\u0131 engellenir. \u0130\u015fte Warfmadin\u2019in yapt\u0131\u011f\u0131 i\u015f tam olarak budur. K vitamininin karaci\u011ferde aktif rol almas\u0131na engel olarak p\u0131ht\u0131la\u015fmay\u0131 belli \u00f6l\u00e7\u00fcde \u00f6nlenmi\u015f olur.<\/span><\/p>

\u00a0<\/span><\/p>

(Umar\u0131m futbol dili, konunun anla\u015f\u0131lmas\u0131na yard\u0131mc\u0131 olmu\u015ftur :)))<\/span><\/p>

\u00a0<\/span><\/p>

Warfmadin ne kadar y\u00fcksek dozda verilirse, K-Vitaminini ve sonu\u00e7 olarak p\u0131ht\u0131la\u015fmay\u0131 o \u00f6l\u00e7\u00fcde engeller. A\u015f\u0131r\u0131 dozlar kullan\u0131ld\u0131\u011f\u0131nda, faydal\u0131 p\u0131ht\u0131lar\u0131n da olu\u015fumu engellenerek, kanamalara ve kanamalar\u0131n durmamas\u0131na neden olur. \u0130\u015fte bu durumlarda damardan K-Vitamini vererek (yani \u00f6nce \u00e7elme takt\u0131\u011f\u0131m\u0131z tak\u0131ma bu sefer yard\u0131m ederek), Warfmadin\u2019in a\u015f\u0131r\u0131 etkisini engelleyebiliriz. Yani diyebiliriz ki; K-Vitamini, Warfmadin ile olu\u015fan a\u015f\u0131r\u0131 etkilerin\/zehirlenmelerin panzehiridir. \u00a0<\/span><\/p>

\u00a0<\/h4>

WARFMAD\u0130N\u2019in Etkisi Nas\u0131l Anla\u015f\u0131l\u0131r?<\/strong><\/span><\/h4>
\u00a0<\/strong><\/span><\/div>

WARFMAD\u0130N a\u011f\u0131zdan al\u0131nd\u0131ktan sonra ince ba\u011f\u0131rsaktan emilir, karaci\u011ferde ve b\u00f6breklerde i\u015flenir. P\u0131ht\u0131la\u015fmay\u0131 \u00f6nleyici etkinin ba\u015flamas\u0131 i\u00e7in en az 48 saat gereklidir. Etki ortalama 4-5 g\u00fcn sonra istenen d\u00fczeylerde olacakt\u0131r. Bu nedenle e\u011fer kan\u0131 hemen suland\u0131rmak isteyece\u011fimiz \u00f6nemli bir durum varsa, Warfmadin\u2019in etkisi hemen ba\u015flamayaca\u011f\u0131 i\u00e7in, istedi\u011fimiz seviyeye ula\u015fana kadar beraberinde, \u201cheparin\u201d adl\u0131 omuzdan ya da g\u00f6bek \u00e7evresinden yap\u0131lan kan suland\u0131r\u0131c\u0131 i\u011fneyi de kullanmam\u0131z gerekebilir.<\/span><\/p>

\u00a0<\/span><\/p>

\"\"Yukarda bahsetti\u011fimiz gibi Warfmadin olduk\u00e7a de\u011fi\u015fken bir etkiye sahiptir. Ayn\u0131 ki\u015fide ayn\u0131 dozda kullan\u0131lmaya devam edilse bile a\u015fa\u011f\u0131da belirtece\u011fimiz bir\u00e7ok fakt\u00f6re ba\u011fl\u0131 olarak etkisi de\u011fi\u015fkenlik g\u00f6sterebilir. \u0130\u015fte bunca de\u011fi\u015fkenlik\u00a0 i\u00e7inde, hastam\u0131zda p\u0131ht\u0131 olu\u015fumunu engelleme hedefimize ula\u015f\u0131p ula\u015famad\u0131\u011f\u0131m\u0131z\u0131 \u00f6l\u00e7ebilmemiz gerekmektedir.<\/span><\/p>

\u00a0<\/span><\/p>

Bunun i\u00e7in kulland\u0131\u011f\u0131m\u0131z test Protrombin Zaman\u0131 (PT) ve onun uluslararas\u0131 standardize edilmi\u015f hali olan \u201cINR TEST\u0130\u201ddir.\u00a0<\/span>INR\u2019nin normal insanlardaki de\u011feri 1.0 civar\u0131ndad\u0131r. Warfmadin kulland\u0131k\u00e7a INR\u2019nin y\u00fckselmesi, kan\u0131n suland\u0131\u011f\u0131 anlam\u0131na gelir.<\/span><\/p>

\u00a0<\/span><\/p>

\u00a0<\/strong><\/span><\/h4>

INR Ka\u00e7 Olmal\u0131d\u0131r?<\/strong><\/span><\/h4>
\u00a0<\/div>
Warfmadin kullanan ki\u015filerde bu de\u011ferin ne olaca\u011f\u0131 hastal\u0131\u011f\u0131n \u00e7e\u015fidine g\u00f6re doktor taraf\u0131ndan belirlenir. A\u015fa\u011f\u0131daki tabloda, hangi hastal\u0131kta genellikle hangi INR de\u011ferini hedefledi\u011fimizi g\u00f6rebilirsiniz. <\/span>Doktorunuz sizin i\u00e7in mevcut durumunuza g\u00f6re farkl\u0131 hedef INR seviyeleri belirleyebilir.<\/span><\/div>
\u00a0<\/div>

\"\"<\/a><\/p>

\u00a0<\/u><\/span><\/p>

\u00d6l\u00e7\u00fcmlerde hedef aral\u0131\u011f\u0131n d\u0131\u015f\u0131ndaki de\u011ferlerde mutlaka doktorunuzla g\u00f6r\u00fc\u015fmelisiniz.<\/u><\/span><\/p>

\u00a0<\/u><\/span><\/p>

E\u011fer INR de\u011feri 5 ve \u00fczerinde ise <\/strong>hemen WARFMAD\u0130N almay\u0131 kesip doktorunuz ile g\u00f6r\u00fc\u015fmeniz gerekir.<\/span><\/p>

\u00a0<\/span><\/p>

E\u011fer INR 10 ve \u00fczerinde ise <\/strong>veya Warfmadin kullan\u0131rken herhangi bir ola\u011fan d\u0131\u015f\u0131 kanama varsa (kendili\u011finden di\u015feti kanamas\u0131, burun kanamas\u0131, g\u00f6ze kan oturmas\u0131, idrardan veya d\u0131\u015fk\u0131dan kan gelmesi, travma olmaks\u0131z\u0131n v\u00fccutta morluklar vb.) hemen<\/strong>\u00a0WARFMAD\u0130N\u2018i kesip doktorunuza veya en yak\u0131n sa\u011fl\u0131k kurulu\u015funa ba\u015fvurun.<\/strong><\/span><\/p>

\u00a0<\/strong><\/span><\/p>

\u00a0<\/strong><\/span><\/p>

WARFMAD\u0130N Nas\u0131l Kullan\u0131l\u0131r?<\/strong><\/span>\u00a0<\/strong><\/span><\/h4>
\u00a0<\/strong><\/span><\/div>

WARFMAD\u0130N a\u011f\u0131zdan g\u00fcnde tek doz olarak al\u0131n\u0131r. Genellikle her g\u00fcn 5 mg (1 tablet) olarak ba\u015flan\u0131r. Y\u00fcksek dozla ba\u015flamak \u00f6nerilmez. \u00c7ocuklarda, ya\u015fl\u0131 hastalarda, ba\u015fka hastal\u0131\u011f\u0131 olanlarda daha d\u00fc\u015f\u00fck dozda ba\u015flamak gerekebilir…<\/span><\/p>

\u00a0<\/span><\/p>

\u0130laca ba\u015flamadan \u00f6nce v\u00fccudun normal (bazal) PT-INR de\u011ferleri belirlenir. \u0130laca ba\u015flad\u0131ktan 5-7 g\u00fcn sonra INR \u00f6l\u00e7\u00fcm\u00fc yap\u0131l\u0131r. Sonuca g\u00f6re doz ayarlan\u0131p k\u0131sa s\u00fcre sonra tekrar INR bak\u0131l\u0131r. Hedef seviyelere ula\u015f\u0131nca da her ay bir kez \u00f6l\u00e7\u00fcm mutlaka yap\u0131lmal\u0131d\u0131r.<\/span><\/p>

\u00a0<\/span><\/p>

\u0130lac\u0131 her g\u00fcn ayn\u0131 saatte almak \u00f6nemlidir. \u0130la\u00e7 ve g\u0131da etkile\u015fimlerinden ka\u00e7\u0131nmak ve bu \u015fekilde daha sabit bir INR de\u011feri sa\u011flamak i\u00e7in, di\u011fer ila\u00e7lar ve yemeklerden en az 1.5 saat, tercihen 2 saat \u00f6nce ya da sonra, \u00a0bir bardak su ile al\u0131nmal\u0131d\u0131r. En uygun saat \u00f6\u011flen ve ak\u015fam yemeklerinin ortas\u0131na denk gelen saat 15:00 \u00a0\u2013 16:00 civar\u0131 ya da gece yatmaya yak\u0131n saatlerde almakt\u0131r.<\/b><\/span><\/p>

\u00a0<\/span><\/p>

Ben genellikle hastalar\u0131ma \u201cgece yatmadan hemen \u00f6nce, bo\u015f mideye, \u00a0en az bir bardak su ile \u201d al\u0131nmas\u0131 tavsiye ediyorum. \u00a0Bu saatin di\u011fer ila\u00e7lar ve yiyeceklerden en uzak saat oldu\u011funu ve hat\u0131rlanmas\u0131n\u0131n daha kolay oldu\u011funu d\u00fc\u015f\u00fcn\u00fcyorum. Takip etti\u011fim hastalar\u0131mda da, bu saatte al\u0131nan WARFMAD\u0130N ile, uyumun daha iyi oldu\u011funu, \u00a0ila\u00e7 unutman\u0131n daha az oldu\u011funu ve daha sabit bir INR seviyesinin yakaland\u0131\u011f\u0131n\u0131 g\u00f6zlemliyorum. Hastalar\u0131m\u0131z kendilerine en uygun olan saati se\u00e7ebilirler.<\/strong><\/span><\/p>

\u00a0<\/strong><\/span><\/p>

\u00a0<\/strong><\/span><\/p>

WARFMAD\u0130N Almay\u0131 Unutursan\u0131z !<\/strong><\/span><\/h4>
\u00a0<\/strong><\/span><\/div>