PT/INR management

The prothrombin time (PT) is a test that assesses your capacity to appropriately form blood clots. The international normalized ratio or INR is a calculation dependent on results of a PT that is used to monitor individual who are being treated with the blood-thinning medication (anticoagulant) warfarin.

A PT measures the number of seconds it takes for a coagulation to form in your sample of blood after substances (reagents) are added. The PT is frequently performed alongside a partial thromboplastin time (PTT) and together they evaluate the amount and function of proteins called coagulation factors that are a significant part of proper blood clot formation.

In the body, when there is a physical injury and bleeding happens, the coagulating cycle called hemostasis starts. This cycle includes to a limited extent a progression of successive synthetic responses called the coagulation cycle, in which coagulation or “thickening” factors are activated consistently and result in the formation of coagulation. There should be an adequate amount of every coagulation factor, and each should work properly, all together for normal clotting to happen.


The prothrombin time (PT) is used, often alongside a partial thromboplastin time (PTT), to help analyze the reason for unexplained bleeding or inappropriate blood clots.

The PT and INR are used to see the viability of the anticoagulant warfarin. Warfarin is prescribed for individuals with many conditions to “thin” their blood and prevent improper clotting. A doctor will normally recommend warfarin and measure how well that dose “thinning” the blood using the PT/INR. The dose might be changed up or down depending upon the outcome and to ensure the dose is adequate in forming clots without causing excessive bleeding. This balance requires careful monitoring.

Warfarin may be prescribed in following conditions:

  • Atrial fibrillation. (Abnormal heart rhythms)
  • If there are artificial heart valves.
  • Pulmonary embolism
  • Deep vein thrombosis.
  • Antiphospholipid syndrome.
  • Heart attacks with some risk factors.


Treating patients who have received an excessive amount of warfarin can be complicated. Most patients who have a high INR however are not bleeding can be dealt with simple dosage of oral phytomenadione and an increased frequency of INR monitoring.

However, in certain conditions, warfarin can cause extreme and hazardous bleeding, whether or not the INR is raised or not.

Such patients may require new frozen plasma or prothrombin complex concentrates to replenish their stores of vitamin K-depending coagulating factors.

They are used for a few signs, including thromboprophylaxis for patients with atrial fibrillation, or who have gone through a mechanical heart valve replacement or had deep vein thrombosis (DVT). They are likewise used to treat current DVTs or pulmonary emboli.

Proper administration of warfarin treatment requires observing of patients international normalized ratio (INRs). While drug specialists regularly monitor their patients’ INRs, it is normally specialists who manage patients who have become over-anticoagulated.

You get this facility at DFW Physicians and Medical Associates in presence of qualified cardiologists. Must visit them if you need appointment of cardiologist.