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Revista Médica del Uruguay

On-line version ISSN 1688-0390

Abstract

RAGGIO, Víctor et al. Respuesta terapéutica inadecuada a la warfarina en un paciente genéticamente susceptible. Rev. Méd. Urug. [online]. 2005, vol.21, n.3, pp.242-246. ISSN 1688-0390.

Summary Warfarin is one of the most used oral anticoagulant whose dosage needs a serologic assessment (INR: International Normalized Ratio) due to its narrow therapeutic range and the virtually severe secondary effects. The main metabolizer of warfarin is the codified enzime for CYP2C9 gene. There are two variants of this gene, relatively frequent, that determine a ‘poor metabolizer’ phenotype. Carriers of these variant alleles are at higher risk of bleeding during oral anticoagulation and need low warfarin doses to reach anticoagulation. A clinical case of a patient under prolilactic warfarin treatment who presented a peek increase of INR and an hematuria episode is reported. The genotype of the patient was analized showing that it was homocygote for one allele (genotype: CYP2C9 *3/*3). Application of pharmacogenetic in clinical management and the prevention of secondary effects are discussed

Keywords : WARFARINA [efectos adversos]; FARMACOGENÉTICA.

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