Warfarin reversal — FRCA Primary MCQ

Instant feedback + full explanation. One question, done properly.

EasyPharmacologyWarfarin reversalFRCA Primary

A patient on warfarin has life-threatening intra-abdominal bleeding and needs emergency laparotomy. The INR is 5.0. Which drug is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Four-factor prothrombin complex concentrate with vitamin K

Four-factor prothrombin complex concentrate rapidly replaces vitamin K-dependent factors, while vitamin K sustains reversal of warfarin. Salbutamol is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Clopidogrel is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Phenylephrine is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Nitrous oxide is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. In Primary FRCA pharmacology, link the clinical effect to the receptor, distribution or elimination mechanism rather than memorising isolated facts.

Reference: Peck, Hill & Williams Pharmacology for Anaesthesia and Intensive Care; BNF; Primary FRCA textbooks