Mech: Interferes with normal synthesis and gamma-carboxylation of vitK dependent clotting factors II, VII, IX, X and proteins C and S. Metabolized by P450 pathway. In lab assay, has effect on extrinsic pathway and increased PT. Long half life.
Use: Chronic anticoagulation (post STEMI, venous thromboembolism prophylaxis). Not used in pregnant women (bc warfarin, unlike heparin, can cross the placenta). Follow PT, INR values.
Tox: Bleeding, teratogenic, skin/tissue necrosis, drug-drug interactions.