Warfarissimo: Missed dose of acenocoumarol

Missed dose of acenocoumarol

Figure 1 shows the INR dynamic of a simulated case on stable anticoagulation with acenocoumarol with a therapeutic target of INR=2.0, of average sensibility to the drug, who misses one dose (that in day 20). This leads to the simulated case having an INR under the therapeutic target for about 72 hours.

Figure 1
Simulated INR trend in a simulated case receiving 2mg Acenocoumarol/day. Time is on the x axis. Numbered segments on the x axis represent days. Each of them is divided in four larger intervals of 6 hours each, the smallest intervals representing 2 hours each. The predicted INR value is the continuous red line; the scale for the INR is at the left. The intensity of the purple in the background is supposed to be indicative of the intensity of anticoagulation. The dose of acenocoumarol is depicted with the green bars, according to the first scale on the right.
You can load the data for this simulation, perhaps change it and try a new scenario.

If the dose is actually taken after, say, a 12 hour delay, the duration under the 2.0 target is reduced to 24 hours, as shown below.

Figure 2
One daily dose delayed for 12 hours.
Rerun this simulation.

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