DR_K
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Q) which of the following statements regarding warfarin is true?
(A) it is a pro drug converted to its active metabolite spontaneously in the blood.
(B) it has low lipophilicity and does not cross BBB.
(C) it causes depletion in protein C b4 it decreases prothrombin.
(D) it inhibitd release of vit K-dependant clootong factors from hepatocytes.
(E) it is inactiviated by protamine.
thsi question given in the end of blood chapter in kaplan Q-4 to be exact the answer is C but i think both C and D are correct, what do u guys thinks???????????????
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| new_n_lost
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Well maybe Kaplan is being technical on the point that Choice D says that Warfarin inhibits the RELEASE while its said that it inhibits the Synthesis of Vit-K dependent clotting factors
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| tilingo
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i hate kaplan questions.. it's not even a smart question..
prot C & S go down first.. that's why warfarin can produce a paradoxical hypercoagulability that it is clinically traduced to skin necrosis...
warfarin inhibit the epoxidase reductase... thus it does create clotting factors.. but it just create deficient clotting factors...
well.. please correct me if I am wrong..
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| DR_K
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oh yes i think u r right new_n_lost i couldnt figure that out thanks.
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| DR_K
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warfarin actually decreases protein C and factor 7 in the intial phase (as they have shortest half lives) the procoagulant effect of warfrin in intial phase is due to depletion of protein c(which is the natural endogeneous anticoagulant) that is why we give heparin with warfarin to decrease its initial procoagulant effect.i think thats the thing u were asking tilingo,is it???
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| tilingo
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yeah.. you get it...
there are 2 reason why you start heparin before warfarin.... the first one we just mentioned.. and the other one is that warfarin will take 3 - 5 days to take effect...
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| vaibhavbora
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as for option d ,, warfarin decreases synthesis , by dec. gamma carboxylation .. ,, not release ,,, 
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