QUESTION 5 Which of the following complications might your patient from problem

Question

QUESTION 5 Which of the following complications might your patient from problem #4 experience as a result of drug interactions? a. thromboembolic stroke because he is inadequately anticoagulated b. heart attack because he is inadequately anticoagulated c. GI bleeding because of toxic warfarin levels d. An infection that will not clear due to sub-therapeutic Bactrim levels

#4

A patient with atrial fibrillation is taking warfarin (Coumadin), which is significantly protein-bound. The patient develops sinusitis and is started on trimethoprim-sulfamethoxazole (Bactrim) to treat his infection. You are checking for drug interactions and learn that Bactrim has a stronger affinity for albumin than warfarin. What will happen to free warfarin levels in the blood once the antibiotic is started?

Warfarin levels will increase.

Warfarin levels will decrease.

Warfarin levels will not change.

Warfarin levels will be undetectable.

Warfarin levels will increase.

Warfarin levels will decrease.

Warfarin levels will not change.

Warfarin levels will be undetectable.

Explanation / Answer

4. Answer is Option A

Bactrim has affinity to cause thrombocytopenia due to reduced platelets count. So the warfarrin level also tend to increase.

5 Answer is option C

Due to the administration of bactrim, platelets count decreased and thrombocytopenia occur. The warfarrin level increased abnormally. So patient may develop GI bleeding.

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