A paramedic's guide to warfarin and the INR

A paramedic's guide to warfarin and the INR


About

Anticoagulants are a commonly prescribed class of medication that paramedics encounter in their day-to-day work. Warfarin has been used as an anticoagulant since the mid 1950s and despite the rise of newer direct oral anticoagulants (DOACs), warfarin is still used today in the management of specific conditions. Patients on warfarin require ongoing testing to ensure their international normalised ratio (INR) levels are within the therapeutic range and they often share results with paramedics.

In this course, we review how to include results in the clinical assessment, the pharmacokinetics of warfarin, compare warfarin with newer DOACs, and explain which medication is preferred in different conditions. We explain what an INR is, how it's measured, and what foods, medications, and supplements can affect it.

By the end of this microlearning, you should be able to:

  • Explain the mechanism of action of warfarin within the coagulation cascade, specifically its inhibition of vitamin K-dependent clotting factors.
  • Differentiate between warfarin and direct oral anticoagulants (DOACs) in terms of indications, mechanism, and monitoring requirements.
  • Interpret INR results and determine the appropriate therapeutic ranges for specific clinical conditions (e.g. Antiphospholipid Syndrome vs. mechanical heart valves).
  • Develop a targeted history-taking strategy for a patient on warfarin that addresses potential drug interactions and contraindications.

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Details

New Release


Length

25 minutes

Released

11th Dec 2025

Cost

Member free
Non-member free

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The College is the peak professional body representing and supporting paramedics and student paramedics across Australia and Aotearoa New Zealand since 1973.

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