CLASS:

NURS-6521N: Advanced Pharmacology

1. A 52-year-old man was recently discharged from the hospital following treatment for atrial fibrillation. He was discharged on Warfarin 5 mg po q day and Amiodarone 200 mg tid. His INR is 8.8. What interaction has occurred with these 2 medications? What changes in his medications would you make?
2. A 44-year-old women is currently taking Glipizide and Phenytoin. She has a new prescription for Ceftriaxone. All three medications are known to be highly protein bound. What effect does protein binding have on drug availability? How would you manage this patient’s medication?
3. Name two drugs that are highly affected by the first pass effect. As a prescriber, what actions would you take in prescribing these drugs to counter the first pass effect?
4. James is a 49-year-old male that was prescribed atenolol for his high blood pressure. James states that he only occasionally takes the medication because he does not like the side effects. What information would you provide to the patient at his visit? How would you manage his medication?

Solution

1. A 52-year-old man was recently discharged from the hospital following treatment for atrial fibrillation. He was discharged on Warfarin 5 mg po q day and Amiodarone 200 mg tid. His INR is 8.8.What interaction has occurred with these 2 medications? What changes in his medications would you make?

In this situation, the interaction is the increase in Warfarin’s anticoagulant impact caused by Amiodarone. According to Thai et al. (2023), this interaction can raise the chances of bleeding complications, including potentially fatal bleeding episodes. For both prevention and treatment of blood clots, doctors often prescribe warfarin, an oral anticoagulant. It prevents blood clots in the liver by blocking components that rely on vitamin K. For the majority of indications, the goal……………..$10