The nurse is reviewing the patient's medication prior to the ...

[Jkov05]

The nurse is reviewing the patient's medication prior to the medication pass and realizes that gemfibrozil (Lopid) and warfarin (Coumadin) are to be administered concomitantly. This finding concerns the nurse, who is aware that the _______ will be _______
 
  a. level of gemfibrozil; increased
  b. level of gemfibrozil; reduced
  c. anticoagulant effects; increased
  d. anticoagulant effects; reduced

Question 2

The nurse is providing patient education about colesevelam (Welchol), a bile acid sequestrant. Which statement made by the patient demonstrates a need for further teaching?
 
  a. Colesevelam will reduce my levels of low-density lipoprotein.
  b. Colesevelam will augment my statin drug therapy.
  c. I will not have to worry about having as many drug interactions as I did when I took cholestyramine.
  d. I may have diarrhea when taking colesevelam.

[leannegxo]

Answer to Question 1

ANS: C
Gemfibrozil displaces warfarin from the plasma albumin, thereby increasing anticoagulant effects. The level of gemfibrozil will not be increased or decreased.
The anticoagulation effects will not be reduced, because free-floating drug is present in the system; the dosage of warfarin may need to be reduced.

Answer to Question 2

ANS: D
Colesevelam does not cause diarrhea, but it could predispose the patient to abdominal bloating, flatulence, and cramping.
Colesevelam reduces the LDL level, which is one of its therapeutic uses; no further teaching is needed.
Colesevelam augments statin therapy; no further teaching is needed.
Colesevelam does not significantly interact with or reduce the absorption of statins, digoxin, warfarin, or most other drugs; no further teaching is needed.

[Jkov05]

Excellent

[isabelt_18]

TYSM