A patient is diagnosed with hypertension.
What is the initial recommendation for this patient likely to be?

Vitamin K is the antidote for warfarin toxicity because it can reverse the effects of warfarin by restoring the clotting factors.Warfarin is an oral anticoagulant that works by inhibiting vitamin K epoxide reductase, an enzyme that activates vitamin K in the body.Vitamin K is needed for the synthesis of active coagulation factors, such as II, VII, IX and X.By blocking vitamin K, warfarin reduces the blood’s clotting activity and prevents the formation of blood clots.

Choice A is wrong because vitamin B12 is not involved in the coagulation cascade.Vitamin B12 is mainly involved in DNA synthesis, red blood cell production and nerve function.

Choice C is wrong because calcium gluconate is not an antidote for warfarin toxicity.Calcium gluconate is used to treat low blood calcium levels or hypocalcemia.Calcium is also a cofactor for some coagulation factors, but it does not reverse the effects of warfarin.

Choice D is wrong because protamine sulfate is not an antidote for warfarin toxicity.

Protamine sulfate is used to reverse the effects of heparin, another type of anticoagulant that works by inhibiting thrombin and factor Xa.

Protamine sulfate does not affect the vitamin K-dependent coagulation factors that are inhibited by warfarin.

Normal ranges for coagulation tests that are affected by warfarin are:

• Prothrombin time (PT): 11 to 13.5 seconds

• International normalized ratio (INR): 0.8 to 1.2

• Activated partial thromboplastin time (aPTT): 25 to 35 seconds

HDL stands for high-density lipoprotein, which is a type of cholesterol that carries excess cholesterol from other parts of the body back to the liver, where it can be removed.HDL cholesterol is often called the “good” cholesterol because it helps protect against heart disease by lowering the amount of plaque buildup in the arteries.Increasing HDL cholesterol levels can reduce the risk of cardiovascular disease in patients.

Choice A is wrong because increasing LDL cholesterol levels would have the opposite effect.

LDL stands for low-density lipoprotein, which is a type of cholesterol that carries cholesterol from the liver to other parts of the body, where it can accumulate in the walls of the arteries and form plaque.

LDL cholesterol is often called the “bad” cholesterol because it increases the risk of heart disease by narrowing and hardening the arteries.Decreasing LDL cholesterol levels can reduce the risk of cardiovascular disease in patients.

Choice C is wrong because increasing triglyceride levels would also increase the risk of cardiovascular disease.

Triglycerides are a type of fat (lipid) that circulates in the blood and provides energy for the body.

However, when triglycerides are too high, they can contribute to plaque formation in the arteries and inflammation of the pancreas.

High triglycerides are often associated with obesity, diabetes, metabolic syndrome, and low thyroid levels.Lowering triglyceride levels can reduce the risk of cardiovascular disease in patients.

Choice D is wrong because increasing intake of saturated fats would also increase the risk of cardiovascular disease.

Saturated fats are a type of fat that are solid at room temperature and are found mostly in animal products, such as meat, butter, cheese, and cream.

Saturated fats can raise both LDL and HDL cholesterol levels, but they also increase inflammation and oxidative stress in the body, which can damage the blood vessels and increase the risk of heart disease.Reducing intake of saturated fats and replacing them with unsaturated fats, such as olive oil, nuts, seeds, and fish, can reduce the risk of cardiovascular disease in patients.

The normal ranges for blood lipid levels are as follows:

• Total cholesterol: less than 200 mg/dL (5.2 mmol/L)

• LDL cholesterol: less than 100 mg/dL (2.6 mmol/L)

• HDL cholesterol: 40 mg/dL (1.0 mmol/L) or higher for men; 50 mg/dL (1.3 mmol/L) or higher for women

• Triglycerides: less than 150 mg/dL (1.7 mmol/L)