DISEASE: Coumarin resistance
Warfarin is widely prescribed anticoagulant for the prevention of thromboembolic diseases. However, its use is made difficult by the wide interindividual variation in dose required to achieve a therapeutic effect, the narrow therapeutic range, and the risk of serious bleeding. Warfarin dose requirement is influenced by factors such as intake of vitamin K, ethnicity, age, gender, and genetic factors. Warfarin acts through interference with the recycling of vitamin K in the liver. It has been reported that mutations in VKORC1, CYP2C9, and GGCX cause warfarin resistance.
Inherited metabolic disease
Human diseases [BR:
Congenital disorders of metabolism
Other congenital disorders of metabolism
H01205 Coumarin resistance
Drug metabolism - cytochrome P450
Osinbowale O, Al Malki M, Schade A, Bartholomew JR
An algorithm for managing warfarin resistance.
Cleve Clin J Med 76:724-30 (2009)
Wadelius M, Chen LY, Eriksson N, Bumpstead S, Ghori J, Wadelius C, Bentley D, McGinnis R, Deloukas P
Association of warfarin dose with genes involved in its action and metabolism.
Hum Genet 121:23-34 (2007)
Pelkonen O, Rautio A, Raunio H, Pasanen M
CYP2A6: a human coumarin 7-hydroxylase.
Toxicology 144:139-47 (2000)
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