A patient is admitted to the hospital, and the provider orders ...

[a0266361136]

A patient is admitted to the hospital, and the provider orders gemfibrozil (Lopid) 600 mg twice daily, 30 minutes prior to meals. The nurse learns that the patient takes warfarin (Coumadin) once daily.
 
  The nurse will contact the provider to discuss
  a. decreasing the dose of gemfibrozil.
  b. giving the warfarin at noon.
  c. increasing the dose of warfarin.
  d. ordering frequent INR levels.

Question 2

A patient has been taking atorvastatin (Lipitor) for several months to treat hyperlipidemia. The patient reports muscle weakness and tenderness. The nurse will counsel the patient to
 
  a. ask the provider about switching to simvastatin.
  b. contact the provider to report these symptoms.
  c. start taking ibuprofen to combat these effects.
  d. stop taking the medication immediately.

[bdobbins]

Answer to Question 1

ANS: D
Gemfibrozil is highly protein-bound and competes for receptor sites with drugs such as warfarin. The anticoagulant dose should be decreased, and the INR should be closely monitored. Decreasing the dose of gemfibrozil is not recommended. Giving the warfarin at a different time of day does not change this drug interaction. The warfarin dose should be decreased not increased.

Answer to Question 2

ANS: B
Patients taking statins should report immediately any muscle aches or weakness, which can lead to rhabdomyolysis, a muscle disintegration that can become fatal. All statins carry this risk, so changing to another statin is not indicated. Ibuprofen may be useful, but notifying the provider is essential. Patients should not abruptly discontinue statins without discussing this with the provider.

[a0266361136]

TYSM

[marict]

Excellent