A patient on warfarin requires urgent surgery. Which agent most rapidly reverses warfarin-induced coagulopathy?
- A Vitamin K1 (phytonadione) intravenous
- B Fresh frozen plasma
- C Prothrombin complex concentrate (PCC) 4-factor ✓
- D Protamine sulfate intravenous
Correct answer: C. Prothrombin complex concentrate (PCC) 4-factor
Explanation
Four-factor prothrombin complex concentrate (PCC) contains factors II, VII, IX, and X in concentrated form and immediately reverses warfarin's anticoagulation effect within minutes, normalizing INR. FFP also works but requires large volumes and takes 30–60 minutes. Vitamin K reverses warfarin by resynthesizing carboxylated factors but takes 6–24 hours to fully work; it is used alongside PCC for durable reversal. Protamine reverses heparin/LMWH, not warfarin.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.