Warfarin Therapy

THE coumarin anticoagulants are widely used in the management of thromboembolic vascular disease. Of the coumarin agents, sodium warfarin is the most frequently employed in the United States. Recent studies have advanced our understanding of the pharmacology of warfarin and allow a reassessment of current practice in the initiation and maintenance of warfarin therapy.Warfarin is a water-soluble derivative of coumaric acid. When given by mouth, it is absorbed completely from the small intestine. It is transported in the blood, loosely bound to albumin. Its distribution in the body and in body fluids, therefore, is essentially the "albumin space." However, . . .