Use the following case study to answer questions 17 and 18. …

Questions

Use the fоllоwing cаse study tо аnswer questions 17 аnd 18.  Lois, age 54, is taking warfarin (Vitamin K antagonist, an anticoagulant) 4 mg p.o. each day following a deep vein thrombosis. Her INRs have been well-maintained at 2.0 – 2.3. Today, however, her INR is 4.8. On review of her history, you note that she has been taking Advil Cold (Ibuprofen, an NSAID + phenylephrine, a decongestant), an over-the-counter cold remedy regularly for the past 3 days.  Other daily medications include atorvastatin (statin) 20mg  and lisinopril (ACE-I) 10mg. She has been on these daily medications and dosages  for several years. A careful history, physical exam, and diagnostic testing reveal no evidence of active bleeding. Given what you know about drug-drug interactions with warfarin (Vitamin K antagonist) and management of elevated INRs, identify appropriate actions to take with this patient.  (Choose as many of the following options as apply). 

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