Question

your 69 year-old patient who has been taking warfarin for chronic atrial fibrillation appears in your office looking pale and complaining of weakness. you check his blood pressure and find it much lower than during his three most recent clinic visits. he mentions having had a dark tarry stool for the past three days, and his lab test indicates a high protrombin time and low hematocrit. when questioned about his recent history he mentions taking otc cimetidine for an upset stomach for the past few days. the most likely explanation for your patient's symptoms is: a. cimetidine induction of warfarin metabolism b. cimetidine inhibition of warfarin metabolism c. cimetidine induced synthesis of clotting factors d. cimetidine interfering with warfarin absorption e. cimetidine reducing the anticoagulant effect of warfarin

Answer 1

The most likely explanation for your patient's symptoms is cimetidine inhibition of warfarin metabolism.

What is cimetidine inhibition?

• A number of cytochrome P450 (CYP) enzymes, including CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP2E1, and CYP3A4, are strongly inhibited by cimetidine.
• The medication is a mild inhibitor of the CYPs it appears to primarily inhibit: CYP1A2, CYP2D6, and CYP3A4.
• In vivo and in vitro in rats and people, cimetidine inhibits hepatic cytochrome P450 (CYP).
• To block drug metabolism in hepatic microsomes in vitro, cimetidine concentrations must be 100–1000 times greater than those linked to a comparable level of inhibition in vivo.

To learn more about cimetidine, refer:

brainly.com/question/28198515

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