A 60 year old female patient presents to the emergency department with complaints of swelling and pain in her right leg. She recently had her knee replaced and has healed well since the procedure. She has a PMH of HTN and CKD (Stage IV). She has no other complaints at this time. She is diagnosed with a proximal DVT on lower extremity ultrasound and the decision is made to anticoagulate her with warfarin plus a parenteral anticoagulant. Her baseline INR is 1.28. What strategy can we use to initiate her on warfarin to reach a therapeutic INR in a reasonable amount of time without overanticoagulating her?
