The primary care NP is performing a medication reconciliation on a patient who takes digoxin for congestive heart failure and learns that the patient uses ibuprofen as needed for joint pain. The NP should counsel this patient to:
a. use naproxen (Naprosyn) instead of ibuprofen.
b. increase the dose of digoxin while taking the ibuprofen.
c. use an increased dose of ibuprofen while taking the digoxin.
d. take potassium supplements to minimize the effects of the ibuprofen.
A
Ibuprofen and indomethacin increase the effects of digoxin, so the NP should recommend another NSAID, such as naproxen, that does not have this effect. Increasing the dose of digoxin or the ibuprofen would increase the likelihood of digoxin toxicity further. Potassium should be monitored while taking NSAIDs long-term, but supplements should not be given unless there is a potassium deficiency.
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