warfarin (3) tab x hs (5.

25 mg/wk)

26/04/2559

10/05/2559

13/05/2559

F/U 20/05/2559

INR = 4.33

INR = 1.08

INR = 1.27

INR = ??

20 mg/week

15.75 mg/week mg/week 15.75 mg/wk

17.5 mg/week mg/week
21.25%
11.1%

Warfarin (5) x1 hs
(-admit
) Warfarin
,
(3) 10/05/59
3/4 x1 hs (12/05/59
-)

Simvastatin (40) 1 x hs
Digoxin (0.25) x hs
Simvastatin (40) 1 x hs
Aspirin (81) 1x1 pc
Digoxin (0.25) x hs
Furosemide (40) x 1pc
Aspirin (81) 1x1 pc
Furosemide (40) x 1pc
1x1 hs ()

Warfarin
Warfarin
(5)
(3)
1/2
3/4x1x1
hshs
((-
-
Simvastatin (40) 1 x hs
Digoxin (0.25) x hs
Aspirin (81) 1x1 pc
Furosemide (40) x 1pc