1992•Annals of Internal MedicineRequires access
Aging and Warfarin Therapy
Dennis R. Mungall, Richard White
Open publisher page 29 citations
Abstract
Letters15 November 1992Aging and Warfarin TherapyDennis Mungall, PharmD, Richard White, MDDennis Mungall, PharmD, Richard White, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-10-878 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: Gurwitz and coworkers (1) purport to show that the anticoagulant response to warfarin increases with age due to an "increased sensitivity" to warfarin; however, the ratio of warfarin dose to prothrombin time response used by the authors as the principal measure of sensitivity does not allow the differentiation of pharmacokinetic variability from pharmacologic sensitivity. In a prospective study of 88 chronically treated outpatients, we showed that age does not alter the pharmacodynamic response to warfarin (2).The study by Shepard and coworkers (3), cited in dismissing a change in warfarin pharmacokinetics with age, was limited by a...References1. Gurwitz J, Avorn J, Ross-Degnan D, Choodnovskiy I, and Ansell J. Aging and the anticoagulant response to warfarin therapy. Ann Intern Med. 1992;116:901-4. LinkGoogle Scholar2. Murray B, Coleman R, McWarters D, Ludden T, and Mungall D. Pharmacodynamics of warfarin at steady state. Therapeutic Drug Monit. 1987;9:1-5. CrossrefMedlineGoogle Scholar3. Sheparid A, Hewick D, Moreland T, and Stevenson I. Age as a determinant of sensitivity to warfarin. Br J Clin Pharmacol. 1977;4:315-20. CrossrefMedlineGoogle Scholar4. Robinson C, Mungall D, and Poon M. Quantitation of plasma warfarin concentrations by high performance liquid chromatography. Therapeutic Drug Monit. 1981;3:287-90. CrossrefMedlineGoogle Scholar5. Mungall D, Ludden T, Marshall J, Hawkins D, Talbert R, and Crawford M. Population pharmacokinetics of racemic warfarin in adult patients. J Pharmacok and Biopharm. 1985;13:213-26. CrossrefMedlineGoogle Scholar1. Gurwitz J, Avorn J, Ross-Degnan D, Choodnovskiy I, and Ansell J. Aging and the anticoagulant response to warfarin therapy. Ann Intern Med. 1992;116:901-4. LinkGoogle Scholar2. Shepherd A, Hewick D, Moreland T, and Stevenson I. Age as a determinant of sensitivity to warfarin. Br J Clin Pharmacol. 1977;4:315-20. CrossrefMedlineGoogle Scholar3. Mungall D, Ludden T, Marshall J, Hawkins D, Talbert R, and Crawford M. Population pharmacokinetics of racemic warfarin in adult patients. J Pharmacok Biopharm. 1985;13:213-27. CrossrefMedlineGoogle Scholar4. Murray B, Coleman R, McWaters D, Ludden T, and Mungall D. Pharmacodynamics of warfarin at steady state. Ther Drug Monit. 1987;9:1-5. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Dennis Mungall, PharmD; Richard White, MD PreviousarticleNextarticle