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Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)
4- Oral Anticoagulants

Vitamin K antagonists: warfarin, Dicumarol, Acenocoumarol, phenprocoumon

Description Water-soluble vitamin K antagonist developed as a rodenticide

interferes with synthesis of the vitamin K-dependent clotting proteins,
Mechanism prothrombin (factor II), factors VII, IX, and X. Along with proteins C
of Action
and S.
Side Effect Bleeding, Skin necrosis, and Fetal abnormalities-crosses placenta

Metabolized: CYP: 1A2, 3A4, 2C9, 2C19, 2C*, and 2C18

Mechanism

1) Inhibit Vit K quinone reductase & Vit K epoxide reductase
(Vitamin K Reductase inhibitors)

2) Inhibit conversion of vit k epoxide into active form ➔ inhibit
synthesis of blood clotting factors (II (Prothrombin), VII, IX, X)

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