ADAKAH KITA BOLEH HAMIL KETIKA MENGAMBIL PIL PERANCANG?
ADAKAH KITA BOLEH HAMIL KETIKA...
Right off the bat, we just want to say: don’t worry, the blood thinner that you are taking is carefully dosed by a doctor or pharmacist and has a way lower concentration than the rat poison.
Image credit: Pharmaforte
The blood thinner that we are referring to is called warfarin. Warfarin is a common prescription medication for people with heart or blood circulatory problems. It goes by different brands in Malaysia: Coumadin®, APO-Warfarin® and Orfarin®.
Image credit: MyHEALTH, Ministry of Health Malaysia
Note: It’s important that you don’t identify the dose of your warfarin based on the colours of the pills! As you can see, the red/pink colour can mean two different doses for different brands. It’s best that you remember the dose you need to take, as per the instructions from your doctor. If that’s not possible, at least remember the brand name and colour of the pills.
Warfarin is an anticoagulant, i.e. it works by preventing or reducing the formation of abnormal blood clots in your body. It is usually prescribed by the doctor for the following conditions:
Irregular heartbeat
Replacement heart valve
Blood clot in the leg, causing deep vein thrombosis (DVT)
Blood clot in the lung, causing pulmonary embolism (PE)
Before going for coronary bypass surgery
Major surgeries
Image credit: medical news today
Use of warfarin aims to reduce the risk of stroke and/or venous thromboembolism (blood clots stuck in your leg or lung).
How does warfarin act in the body?
Normally, human blood contains vitamin K which helps blood clotting and prevents continuous bleeding. However, in certain conditions, blood clots may travel to vital organs such as the heart, lungs and brain that can cause blockage of the blood vessels and hence leading to a heart attack or stroke. Therefore, the use of warfarin may help prevent the effect of vitamin K in the blood and prevent the blood clots from getting larger.
In other words, warfarin and vitamin K are in an antagonistic relationship, i.e. they cancel each other’s effects out. Therefore, vitamin K is a good antidote for warfarin poisoning.
Too much warfarin, the blood cannot clot properly and one may bleed excessively; too little warfarin, then abnormal blood clot formation would happen and lead to blockage of blood vessels.
Image credit: Cleaveland clinic
Warfarin was once a rat poison?
Warfarin was the first anticoagulant rodenticide introduced and was first registered for use in the United States in 1948. It is used for controlling rats and house mice in and around homes, animal and agricultural premises, and commercial and industrial sites.
Image credit: Slideshare
It rises to fame as a rodenticide for a few reasons. Firstly, warfarin is odourless, tasteless and effective in very low dosages. Secondly, warfarin’s action is slow in the body; about a week is required before one can notice a significant reduction of the rat’s population. This is an advantage because the rats do not tend to become “bait-shy” after once tasting warfarin. Bait shyness occurs when a fast-acting poison makes an animal sick before it has eaten a lethal dose. Further control with any kind of bait becomes more difficult. With warfarin, the rats would come back to taste the warfarin for multiple times until it is killed.
Another advantage of slow action of warfarin is that it makes it easier to handle the poisoning cases, especially when children accidentally ingest rat poison. The average time for warfarin to exert its effects onto the human’s body can take up to 3 days. The slow action of warfarin buys time to send the children to the hospital and be given with vitamin K in time.
Today, many rat poisons in the market contain derivatives of warfarin, such as coumatetralyl. Racumin®, a rodenticide manufactured by Bayer®, contains 0.75% coumatetralyl.
Image credit: Environmental Science.
How is the warfarin I’m taking different than the rat poison?
When we discuss how deadly poison is, it’s useful to look at its LD50. LD50 is the amount of a poison needed to kill 50% of the experimental animal population. The acute oral LD50 for technical sodium warfarin in rats was 323 mg/kg for males and 58 mg/kg for females, which is way higher than the clinical dose of warfarin used in human.
Therefore, it is safe to take the warfarin that is prescribed by your doctor. In fact, it would be more dangerous if you stop taking them because you may end up having abnormal blood clots in your body that can lead to stroke or blood clots in the lungs or legs.
Image credit: Medical News Today
If you’re taking warfarin, regular follow-up with doctor or pharmacist is IMPORTANT
Unlike other medication, the amount of warfarin you need to take very much depends on a reading called International Normalised Ratio (INR). INR reading shows the rate of blood clotting in your body. This reading can be obtained through a regular blood test.
Your doctor/pharmacist will adjust the amount of warfarin you need to take based on this monitoring. That is why it is very important that you do not skip the follow-up with your healthcare professional and do not ever change the amount of warfarin without consulting them.
Image credit: Vital Record
References:
http://pmep.cce.cornell.edu/profiles/extoxnet/pyrethrins-ziram/warfarin-ext.html#12
https://www.pctonline.com/article/-rodent-control--warfarin--a-forgotten-weapon/
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