A 61-year-old woman undergoes a routine evaluation. She reports no recent changes in her medications and has a history of idiopathic deep venous thrombosis. Her only medication is warfarin, initiated 2 months ago. On physical examination, vital signs are normal, and the examination is unremarkable. She has an INR of 7.2.

In addition to withholding warfarin, which of the following is the most appropriate management?

1) Administer fresh frozen plasma
2) Administer prothrombin complex concentrate
3) Administer vitamin K
4) Remeasure INR in 2 days

Given the high INR of 7.2, which implies a high risk for bleeding, the woman's Warfarin treatment should be regulated. In this scenario, the most appropriate management would be the administration of Vitamin K, which works as an antidote for Warfarin overdose.

Explanation:

In this context, the 61-year-old woman's INR (International Normalized Ratio) is at 7.2, significantly above the normal range, indicating that her blood is thin and she's at a higher risk of bleeding. Her warfarin medication, a type of anticoagulant agents typically given to prevent clotting, is likely the cause.

Given her high INR, the next step would be to correct it to prevent severe bleeding risk while she's on Warfarin. Administering Vitamin K would be the most proper management in this case. It serves as an antidote for Warfarin overdose as it is an important factor in the clotting pathway, involved in the coagulation process, opposing the action of Warfarin.

It's vital to monitor warfarin therapy and adjust dosages as necessary based on INR values and patient's liver function, to prevent both bleeding and thrombosis. While fresh frozen plasma or prothrombin complex could rapidly normalize the INR, this approach would usually be reserved for patients having active bleeding or those needing urgent surgical intervention, which doesn't seem to be the case here.

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