A patient who takes warfarin (Coumadin) and digoxin (Lanoxin) develops hypothyroidism and will begin taking levothyroxine (Synthroid). The nurse anticipates which potential adjustments in dosing for this patient?
a. Decreased digoxin and decreased warfarin
b. Decreased digoxin and increased warfarin
c. Increased digoxin and decreased warfarin
d. Increased digoxin and increased warfarin
ANS: C
Thyroid preparations increase the effect of oral anticoagulants, so the warfarin dose may need to be decreased. Levothyroxine can decrease the effectiveness of digoxin, so this dose may need to be increased.
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