A patient has been taking warfarin (Coumadin), which is highly protein-bound. The patient will begin taking gemfibrozil, which is also highly protein-bound. The nurse will observe the patient closely for
a. decreased effects of warfarin.
b. increased effects of warfarin.
c. decreased effects of gemfibrozil.
d. decreased effects of both drugs.
ANS: B
The addition of a highly protein-bound drug will compete with warfarin for protein- binding sites, releasing more free warfarin into the system, increasing drug effects and increasing the chance of toxicity.
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