How would you test for these possibilities

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Reference no: EM133228026

Case: A 68-year old man is started on warfarin after a small stroke. He is already taking a number of other drugs for various conditions. Anticoagulation is monitored. Within a few days, he experiences a spontaneous nose-bleed and coagulation is found to be much more impaired than expected. At clinical pharmacology consultation, he is able to recall that had before become rapidly intoxicated with a drug once before. That time it was the anticonvulsant phenytoin, which had to be stopped.

Question 1: What explanations might you suggest for the excessive response to warfarin?

Question 2: How would you test for these possibilities?

Question 3: How would you manage his warfarin treatment, to make it safe and effective?

Question 4: Why was the reaction to phenytoin a clue to the diagnosis?

Reference no: EM133228026

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