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Pharmacology · single question

What is the MOA of warfarin?

  1. Direct thrombin (factor IIa) inhibition
  2. Direct factor Xa inhibition
  3. Vitamin K antagonism, inhibiting synthesis of clotting factors II, VII, IX, and X (and proteins C/S)
  4. Direct inhibition of platelet COX-1
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Correct answer: C. Vitamin K antagonism, inhibiting synthesis of clotting factors II, VII, IX, and X (and proteins C/S)

Warfarin blocks vitamin K epoxide reductase, preventing the gamma-carboxylation (activation) of vitamin K-dependent clotting factors II, VII, IX, and X, as well as anticoagulant proteins C and S. It is monitored using the INR, and its effect can take days to fully manifest or reverse.

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