Case Study

WD is an 86 yo F who is seen by the internal medicine physician because she has been feeling very depressed. The physician takes a full history from WD, which reveals that several medications have been prescribed to her by a variety of specialists. It seems that each specialist neglected to pay attention to the meds that WD was prescribed by her other doctors and the potential drug-nutrient interactions.

The physician’s notes are as follows:

Current Medication Reason for Prescribing

St. John’s wort WD read in a magazine that this helps with depression

Slow Fe (iron supplement) prior anemia

Warfarin history of embolic stroke

Omeprazole history of embolic stroke

Tums upset stomach

Amoxicillin recent respiratory infection

Doxazosin incontinence

Allegra seasonal allergies

Lipitor high cholesterol

Vitamin E she heard it was “good for heart disease”

Diet hx

B- eggs D- cooked spinach

bacon chicken breast

orange juice mashed potatoes

fruit cocktail

L- Italian hoagie (salami, ham, cheddar cheese, lettuce, and tomato) iced tea

-You notice that WD is taking warfarin You would also advise her regarding which food that could potentially cause a drug-nutrient interaction?

Question

Case Study

WD is an 86 yo F who is seen by the internal medicine physician because she has been feeling very depressed. The physician takes a full history from WD, which reveals that several medications have been prescribed to her by a variety of specialists. It seems that each specialist neglected to pay attention to the meds that WD was prescribed by her other doctors and the potential drug-nutrient interactions.
The physician’s notes are as follows:
Current Medication	Reason for Prescribing
St. John’s wort	WD read in a magazine that this helps with depression
Slow Fe (iron supplement)	prior anemia
Warfarin	history of embolic stroke
Omeprazole	history of embolic stroke
Tums	upset stomach
Amoxicillin	recent respiratory infection
Doxazosin	incontinence
Allegra	seasonal allergies
Lipitor	high cholesterol
Vitamin E	she heard it was “good for heart disease”
Diet hx
B- eggs	D- cooked spinach
bacon	chicken breast
orange juice	mashed potatoes
fruit cocktail
L- Italian hoagie (salami, ham, cheddar cheese, lettuce, and tomato) iced tea

-You notice that WD is taking warfarin You would also advise her regarding which food that could potentially cause a drug-nutrient interaction?

Quizplus · Accepted Answer

Spinach is high in vitamin K, which can interfere with warfarin's ability to thin the blood. It is recommended that people taking warfarin consume a consistent amount of vitamin K daily and limit intake of vitamin K-rich foods. Iced tea, orange juice, and bacon do not have significant interactions with warfarin. Spinach contains high levels of vitamin K which can interact with warfarin and decrease its effectiveness. It is important for WD to limit her intake of vitamin K-containing foods while taking warfarin.