Which laboratory value is routinely monitored to ensure that a patient receiving warfarin (a vitamin K antagonist) remains within a safe therapeutic range and to guide dosage adjustments?
The International Normalized Ratio (INR) is a standardized calculation derived from the prothrombin time that measures the extent of anticoagulation produced by vitamin K antagonists such as warfarin. Clinicians adjust the dose of warfarin to keep the INR in a target therapeutic range (for many indications 2.0-3.0). Monitoring the INR helps prevent thrombotic events when values are too low and bleeding complications when values are too high. Hemoglobin A1c is used for long-term glycemic control, blood urea nitrogen assesses renal function, and LDL cholesterol evaluates lipid status; none of these are used to guide warfarin dosing.
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