Betsy A. is a 72-year-old woman who was recently hospitalized after having a mild stroke. She has been discharged from the hospital on warfarin-a blood thinning medication-and has been advised to continue her usual diet at home. Betsy's doctor also wants her to continue her other medications, which include a diuretic medication, a low-dose daily aspirin, and pravastatin-her cholesterol medication.
Betsy and her husband consume a varied diet. Betsy's husband often barbecues fish, poultry, and meat on their outdoor grill. They eat fresh oranges or grapefruit most mornings and have a mixed green salad with dinner several nights a week. Betsy begins to wonder if her new medication will require her to make any changes in her diet.
1. Based on information in Highlight 17, what are some potential drug-drug or drug-nutrient interactions Betsy may encounter with the addition of warfarin to her medication regimen?
2. Which foods in Betsy's usual diet have the greatest potential to interfere with the therapeutic effect of her new medication? Explain why this is important for Betsy to understand.
3. Why is it important for Betsy to adhere to her doctor's advice to maintain her current diet in regards to taking warfarin?
4. What information about cooking meat and its effect on warfarin activity would be helpful for Betsy and her husband to understand? How might this change their cooking methods?
5. How might Betsy's nutritional status be affected by her diuretic medication? Explain how she can use this information to make daily food choices.
6. Based on her current medication regimen, should Betsy stop eating grapefruit? Why or why not?
7. What is a good course of action for Betsy to follow if she has any questions about the potential interactions of her medications?