SOLVED1628

K.R. is a 65-year-old male who presents to the anticoagulation clinic for follow-up. He has been stable on warfarin 4 mg daily for four months. He recently traveled to Costa Rica and has been taking doxycycline 100mg daily for prophylaxis of malaria. Two days ago, K.R. began vomiting due to a about of food poisoning that has since resolved. He reports he had been taking peppermint oil capsules to try and help with his nausea. His point-of-care INR today is 4.6 (goal INR range 2-3). He does not report any signs or symptoms of bleeding. K.R. was sent for a venipuncture INR, and the result was 3.6. What would you recommend regarding this patient’s warfarin dose and follow-up plan? a. Continue warfarin 4mg daily and repeat INR in 1 month. b. Take warfarin 2mg today, then resume warfarin 4mg daily. Repeat INR in 2 weeks. c. Hold warfarin dose today. Repeat INR in 3 days. d. Decrease warfarin dose to 4mg daily except 2mg Mon/Wed/Fri. Repeat INR in 2 weeks.
SCIENCE
HEALTH SCIENCE
NURSING

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