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 B
Explanation
A. Reduced cardiac output: While liver disease can affect circulation in later stages, abnormal coagulation is a more immediate concern.
B. Abnormal coagulation: The liver plays a vital role in producing proteins essential for blood clotting. Liver damage can impair this function, leading to increased bleeding risk.
C. Electrolyte imbalance: The liver plays a role in some aspects of electrolyte balance, but abnormal coagulation is a more specific and critical complication in early liver damage.
D. Respiratory issues: While liver disease can progress to respiratory complications in severe cases, abnormal coagulation is a more immediate threat.
Correct Answer is D
Explanation
A. Black Cohosh: This herb is more commonly used for menopausal symptoms and not typically associated with immune system benefits.
B. Gingko: Gingko is primarily studied for its potential benefits on memory and cognitive function, not necessarily the immune system.
C. Kava Kava: Kava kava is known for its calming effects and used for anxiety relief, not immune system support.
D. Echinacea: This herb has been widely studied and used for centuries for its potential immune-boosting properties. While research results are somewhat mixed, it's one of the most popular herbs associated with immune support.
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