SOLVED1373
R.J. is a 38-year-old female (62kg) who had an INR drawn today, and the result was 1.6. The patient denies any missed warfarin doses within the past seven days. Her time in the therapeutic range (TTR) is 54%. Her current warfarin dose is 5mg daily except 7.5mg on Mon/Wed/Fri. She has been drinking green tea daily to help with energy. Medical history: â— Deep vein thrombosis (DVT), recurrent, unprovoked â— Antiphospholipid antibody syndrome â— HTN Laboratory values: â— Hematocrit 42.5% (normal 37%-48%) â— Platelet count 208,000/mm3 (normal 150,000-300,000) â— Creatinine clearance (CrCl) 74 mL/minute Current medications: â— Lisinopril/HCTZ 20/12.5mg orally once daily â— Warfarin 5mg every day except 7.5mg on Mon/Wed/Fri â— Ethinyl estradiol 0.03 mg and norgestrel 0.3 mg orally once daily â— Multivitamin orally once daily (she recently switched from K Free Daily to Centrum Women) What other factors may be influencing this patient’s INR? a. Green tea b. Multivitamin c. Lisinopril/HCTZ d. A and B e. All of the above
SCIENCE
HEALTH SCIENCE
NURSING
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