Why was the reaction to phenytoin a clue to the diagnosis

Reference no: EM133251539

Question - 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.

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

How would you test for these possibilities?

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

Why was the reaction to phenytoin a clue to the diagnosis?

Reference no: EM133251539

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