Supratherapeutic INR

[an2on, BSN, RN]

Hello,

I receive my clinical assignment today with a medical diagnosis of 'supratherapeutic INR".

What exactly is supratherapeutic INR?

I've done some research but didn't get a clear answer. From my understanding, supratherpeutic INR means that a patient who is on warfarin or an anticoagulant has maintained a level of the drug above the therapeutic level.

Can someone clarify or add to this?

Thanks

[tarheelsu]

Supra = too much

Look up what INR measures. Look up some anticoagulants in your drug book. How do they work? What would they cause if you had too much of them? What are the adverse effects?

[NightNurseRN13]

I would assume that it puts the patient at a risk for bleeding. Warfarin is a blood thinner and it's important to keep an eye on blood levels to assess if the dosage is too much or too little.

"The goal of anticoagulant therapy with warfarin is to administer the lowest effective dose of the drug to maintain the target international normalized ratio (INR)"

"When a patient is started on an oral anticoagulant, INR monitoring should be performed daily until the INR is within the therapeutic range for at least 2 consecutive days. Unexpected fluctuations in the INR in an otherwise stable patient could be due to a change in diet, poor compliance, undisclosed drug use, alcohol consumption, or self-medication (2). Lab error should also be considered for unexpected values."

"One of the major risks of warfarin therapy is bleeding, which correlates well with INR values"

"Patients who are given a loading dose of warfarin often reach a supratherapeutic INR level that can place a patient at risk for bleeding and prolonged hospital stay"

[an2on, BSN, RN]

Thank you both for the info!

[NightNurseRN13]

I meant to add to my post that I am only a first semester nursing student. I don't want anyone taking my opinion or my posts as solid information. Not yet anyway! :)

[an2on, BSN, RN]

I put all the info together and you are just about right. I am also a first semester student

[an2on, BSN, RN]

Wow really good thanks!

[Esme12, ASN, BSN, RN]

? you're welcome

[xtxrn, ASN, RN]

Look at the other meds the patient is on.....almost all meds effect INR/Coumadin in some way. It's a major PITA. Also, check to see if the patient has had various vit K rich foods lately. (you need to look up what those are :)).