Pharmacokinetics And Pharmacodynamics of Warfarin in Critically Ill Hematological Patients

Background: Warfarin is an anticoagulant that comes in two forms, S-warfarin and R-warfarin, the former being five times more potent and responsible for its anticoagulant effect. Genetic variants in the CYP2C9 gene, such as CYP2C9*2 and CYP2C9*3, may reduce the effectiveness of the enzyme that metabolizes S- warfarin, leading to people with these variants needing lower doses of the drug. Methodology: A bibliographic review was carried out through various databases from 2018 to 2024; The search and selection of articles was carried out in indexed journals in English and Spanish. The following keywords were used: pharmacokinetics, pharmacodynamics, warfarin, patients, hematological. Results: In patients with chronic hematological disorders, the pharmacodynamics of Warfarin is influenced by alterations in coagulation, drug metabolism, response and drug interactions, making the management of anticoagulation more delicate, with a balance between the prevention of thrombosis and the minimization of the risk of bleeding, rigid monitoring of INR, by customizing treatment to the patient's condition, high-risk complications are avoided. Conclusion: Warfarin as a treatment in patients with chronic hematological pathologies can present significant risks as benefits, on the one hand, when we refer to pathologies with a high thrombotic predisposition, Warfarin is a fundamental option for the prevention of serious thrombotic events, in these cases, the ability it has to inhibit the formation of coagulability is crucial.