The nurse instructs a patient on beverages to avoid when taking the prescribed medication warfarin (Coumadin). Which beverage should the patient state that indicates teaching has been effective?
a. Beer
b. Orange juice
c. Grapefruit juice
d. Cranberry juice
ANS: D
Warfarin is mainly metabolized by the cytochrome P450 isoenzyme CYP2C9, and cranberry juice contains flavonoids known to inhibit P450 enzymes. Bleeding problems and hemorrhage have been attributed to this interaction. A. B. C. There is no reason for the patient to avoid these beverages.
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