A patient is receiving warfarin (Coumadin), which is 98% bound to plasma proteins. The antidepressant paroxetine (Paxil), which is 95% bound to plasma proteins, is added to the patient's daily medication. If the paroxetine displaces warfarin from its protein binding sites, which of the following will most likely to occur?
Diminished effect from warfarin
Diminished effect from paroxetine
Increased effect, and toxicity from paroxetine
Increased effect, and toxicity from warfarin
The Correct Answer is D
A. Diminished effect from warfarin: This is unlikely because displacement of warfarin from protein binding sites would increase its concentration in the bloodstream, potentially leading to increased anticoagulant effects and toxicity.
B. Diminished effect from paroxetine: This is also unlikely because displacement of paroxetine from protein binding sites would increase its concentration in the bloodstream, potentially leading to increased pharmacological effects and toxicity.
C. Increased effect, and toxicity from paroxetine: If paroxetine displaces warfarin from protein binding sites, it can increase the concentration of free warfarin in the bloodstream, leading to increased anticoagulant effects and potential toxicity.
D. Increased effect, and toxicity from warfarin: Correct. If warfarin is displaced from protein binding sites by paroxetine, it can increase the concentration of free warfarin in the bloodstream, leading to increased anticoagulant effects and potential toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Nausea and vomiting: Nausea and vomiting can occur with epoetin alfa, but it's not the most common side effect.
B. Orthostatic hypotension: This is not a common side effect of epoetin alfa. Orthostatic hypotension is a decrease in blood pressure upon standing.
C. Hypertension: Epoetin alfa stimulates the production of red blood cells. When the red blood cell count increases too quickly, it can lead to increased blood pressure, which is the most common adverse effect.
D. Dizziness: Dizziness can occur with epoetin alfa, but it's less common than hypertension.
Correct Answer is B
Explanation
A. Have suction equipment at the bedside. Clopidogrel is an antiplatelet medication that inhibits blood clot formation. While it does not typically increase the risk of bleeding to the extent that requires constant suctioning, it's prudent to have suction equipment readily available for any patient who may be at risk of bleeding due to their underlying condition or concurrent medications. However, the administration of clopidogrel alone does not necessitate the need for constant suctioning.
B. Monitor the client for black, tarry stools. This is the correct answer. Clopidogrel, like other antiplatelet medications, increases the risk of bleeding, including gastrointestinal bleeding. Black, tarry stools can indicate gastrointestinal bleeding, which can be a serious complication of clopidogrel therapy. Therefore, monitoring for this symptom is essential for early detection of potential bleeding complications.
C. Administer the medication with each meal. Clopidogrel can be administered with or without food, as it is not significantly affected by food intake. However, there is no specific recommendation to administer it with meals. The timing of administration may vary based on the prescriber's instructions or patient preferences, but it does not need to be consistently administered with meals.
D. Initiate contact precautions. Clopidogrel therapy does not require contact precautions. Contact precautions are typically implemented for patients with contagious infections that spread via direct or indirect contact. Clopidogrel does not pose a risk of transmission to others and does not warrant contact precautions.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.