A patient who has taken warfarin (Coumadin) for a year begins taking carbamazepine. The nurse will anticipate an order to:
a. decrease the dose of carbamazepine.
b. increase the dose of warfarin.
c. perform more frequent aPTT monitoring.
d. provide extra dietary vitamin K.
ANS: B
Carbamazepine is a powerful inducer of hepatic drug-metabolizing enzymes and can accelerate warfarin degradation. The warfarin dose should be increased if the patient begins taking carbamazepine. Decreasing the dose of carbamazepine is not indicated. It is not necessary to perform more frequent aPTT monitoring or to add extra vitamin K.
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