The effect of glucagon and insulin on the prothrombin response to coumarin anticoagulants.

Abstract

Discussion and SummaryThe response to drugs such as the coumarin anticoagulants may be altered by factors which either affect the physiologic disposition of the drug, or the site at which the drug acts. Clues as to the nature of the drug action may be obtained by studying the factors which influence sensitivity to the drugs without altering the fate of the drug.The effect of Vitamin K in blocking the action of coumarin anticoagulants is well documented, and is not correlated with changes in the physiologic disposition of coumarins as reflected in plasma levels of the drug. In contrast, the effect of barbiturates is mediated through altered disposition of the coumarins (1,4). The tranquilizers chlorpromazine and reserpine exaggerate prothrombin response while not influencing plasma levels of the coumarin drug. This effect may be correlated with the action of these agents on NAD synthesis (5).The mechanism by which starvation causes an exaggerated response to coumarins is not known. Elements of protein orig...