Patient presents with angina and is found to have 3 vessel disease for which he undergoes CABG.
Pre-op INR 1.6
Post-op INR >13.6
What did we give him to trigger this? (Hint: it’s not warfarin)
It was actually cefazolin!
There’s a side chain inhibits vitamin K epoxide reductase and/or gamma-gutamyl-carboxylase altering synthesis of vitamin K dependent clotting factors and thus has a warfarin like effect in some patients.
