Information for Patients and Parents

Transcription

1 Warfarin Information Information for Patients and Parents Living with your Child s Warfarin What is Warfarin? Warfarin is an anticoagulant drug. That is, it helps blood flow freely and prevents clotting. It is given to children if they are at risk of forming a blood clot (thrombosis), or if they need treatment for a clot that has already formed. We are keen to treat clots well as they can move in the blood and cause damage in the heart, lungs or brain. Management of Warfarin To find exactly how much Warfarin you should give, your child will have a blood test to measure the International Normalized Ratio (INR). This is a measure of how fast your child s blood will clot. The nurses will recheck the INR in the anticoagulant clinic. The INR will be kept within a target range, set up with the doctors. Warfarin tablets come in three strengths, each of a different colour: 1mg (brown) 3mg (blue) 5mg (pink rarely used). Different strengths of warfarin tablets Warfarin may be given as a syrup using a dosing syringe. We advise that you give the Warfarin regularly. It is probably best to give it in the evening around 6.00 PM.

2 What happens in the paediatric haematology clinic? A sample of blood will be taken from your child s finger or the heel depending on their age. An INR will be measured and the anticoagulant nurse or paediatric doctor will then prescribe the dose of Warfarin. Medicines we need to know about... If your child is put on antibiotics, please let us know, as this can alter the INR for a short time. Please ask if you have any queries about medications or diets that may worry you. Cranberry juice interferes with warfarin and therefore your child must not drink cranberry juice. Do I keep notes of my child s problem? You will be given a yellow anticoagulant booklet with your child s name and emergency contact numbers. The book is used to record each visit to the hospital, blood test or INR results, the INR range and the dose of Warfarin you need to give your child. The anticoagulant nursing team will be able to give you lots of support and will answer any questions you may have. When Warfarin dose adjustment is needed If the Warfarin dose is too low and the INR below the target range, it may not protect against blood clots. If this happens we may need to give an injection of Heparin under the skin for a couple of days. If the INR result is above the target range, bleeding may develop. In this situation we may give your child vitamin K to reduce the Warfarin s effect. Please take your yellow book when collecting prescriptions from your GP. What do I do if my child has a head injury? Most head injuries from knocks and bumps do not cause problems in children taking Warfarin. However, some injuries can result in bleeding inside the head. Symptoms to look out for include: Drowsiness, dizziness, vomiting, fits or convulsions, worsening headache, problems with vision such as blurring.

3 If any of these develop you must take your child to the nearest Accident and Emergency Department. What do I do if my child has a nose bleed? If your child has a nose bleed carry out the usual first aid: Lean the child s head forward and pinch just below the bridge of the nose firmly for at least 10 minutes. If the nose bleed continues present your child to the nearest Accident and Emergency Department. What if my child needs an operation or teeth removed? Warfarin may have to be reduced or stopped a few days before surgery or removal of teeth. Please tell the surgeon, anaesthetist or dentist that your child is on Warfarin. Also tell the anticoagulant staff so arrangements can be made to check your child s INR again. Vaccinations Injections and vaccinations must be given under the skin (subcutaneously) and not into muscle. This will not alter their effectiveness. Menstruation/and use of contraception Girls may have heavier, longer periods if taking Warfarin, but there are medications that can be given to help reduce blood losses. Contraceptive medicines can alter the effect of Warfarin - please tell the nurse if these are being used. Alcohol Alcohol is not recommended as it can cause bleeding. Teenagers will experiment, but it is risky; binge drinking is particularly dangerous. School You must inform the school nurse that your child is on Warfarin so that they know that extra care is needed during play time. A school visit can be arranged by the anticoagulant or paediatric nurses.

4 Playing sports Most exercise is safe but please avoid body contact sports such has rugby, martial arts, boxing for your child. Encourage non-contact sports such as athletics, rowing or swimming. Who do I contact for advice about my child's warfarin? Dr Mamta Sohal (Consultant Haematologist) Dr Richa Ajitsaria (Consultant Paediatrician) Jo Davison/Chris Tapping (Specialist Nurses) Ext or Bleep 5286 For urgent queries or out of hours please contact the on call Paediatric Registrar via switchboard on

5 Languages/ Alternative Formats Please ask if you require this information in other languages, large print or audio format. Please contact: Fadlan waydii haddii aad warbixintan ku rabto luqad ama hab kale. Fadlan la xidhiidh Jeżeli chcialbyś uzyskać te informacje w innym języku, w dużej czcionce lub w formacie audio, poproś pracownika oddzialu o kontakt z biurem informacji pacjenta (patient information) pod numerem telefonu: 如 果 你 需 要 這 些 資 料 的 其 他 語 言 版 本 大 字 体 或 音 頻 格 式, 請 致 電 詢 إذا آنت تود الحصول على هذه المعلومات بلغة أخرى بالا حرف الكبيرة أو بشكل شريط صوتي يرجى الاتصال بالرقم التالي Thanks to Ealing Hospital s Thrombosis Committee and Patient Information Group.