The nurse is conducting a health history on a patient who takes warfarin (Coumadin) 5 mg/day and also reports using an herbal product. Which herbal products would most concern the nurse when taken concurrently with warfarin?
(Select all that apply.)
a. Ginger
b. Ginkgo biloba
c. Feverfew
d. Garlic
e. Kava
ANS: A, B, C, D
Feverfew and ginkgo biloba suppress platelet aggregation, and ginger root and garlic inhibit thromboxane synthesis. These medications would create a greater potential for bleeding in the patient, because they would interact with the anticoagulant effects of warfarin.
Kava does not suppress platelet aggregation.
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