Author Question: A patient has been taking warfarin (Coumadin), which is highly protein-bound. The patient will begin ... (Read 38 times)

mynx · **on:** Jul 23, 2018

A patient has been taking warfarin (Coumadin), which is highly protein-bound. The patient will begin taking gemfibrozil, which is also highly protein-bound. The nurse will observe the patient closely for

a. decreased effects of warfarin.
b. increased effects of warfarin.
c. decreased effects of gemfibrozil.
d. decreased effects of both drugs.

Question 2

A patient is taking phenytoin to prevent seizures. The nurse knows that phenytoin is highly protein-bound and has sedative side effects. The nurse reviews the patient's chart and notes a low serum albumin.

The nurse will notify the provider and observe the patient for which effects?
a. Decreased sedative effects
b. Increased sedative effects
c. Increased seizures
d. No change in effects

gabrielle_lawrence · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: B
The addition of a highly protein-bound drug will compete with warfarin for protein- binding sites, releasing more free warfarin into the system, increasing drug effects and increasing the chance of toxicity.

Answer to Question 2

ANS: B
Phenytoin is protein-bound. When patients have a low serum albumin, there are fewer protein-binding sites, leaving more free drug in the system. The nurse should expect an increase in sedative side effects.