The nurse is preparing to give a dose of trimethoprim-sulfamethoxazole (TMP-SMX) and learns that the patient takes warfarin (Coumadin). The nurse will request an order for
a. a decreased dose of TMP-SMX.
b. a different antibiotic.
c. an increased dose of warfarin.
d. coagulation studies.
ANS: D
Sulfonamides can increase the anticoagulant effects of warfarin. The nurse should request INR levels. An increased dose of warfarin would likely lead to toxicity and to undesirable anticoagulation.
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