You know, it is entirely possible to be in this job going 30 years and still realize that you missed something really important. This happened to me this weekend when I was trying to catch up on CEU’s and found a great free online course about Coumadin.
If you are as old as I am, you probably remember the Classic WKRP in Cincinnati episode where Mr. Carlton says, “As God as my witness, I thought turkeys could fly”. Click here to view it if you missed this 1978 Thanksgiving Classic.
I had my own Mr. Carlton moment this weekend when I read about Coumadin drug interactions. Obviously, it is going to react with other drugs that thin blood like NSAIDs and Aspirin but Bactrim?
I had no earthly idea that Bactrim could affect PT/INR levels. It is a miracle that I don’t have a license to prescribe because I would have never thought twice about prescribing Bactrim or another sulfa drug to a Coumadin patient who had a UTI.
And while I feel a bit foolish, as I review clinical records, it appears that I am not the only one who didn’t know this. If you don’t have time to take the CEU course referenced above, please be aware that it is recommended that Coumadin dosage be reduced by 50 percent while a patient is taking Bactrim and for the following week. And if at all possible, try to persuade the MD to use another antibiotic (but not a mycin) if there is an effective alternative.
On the lighter side of things, I did know that turkeys couldn’t fly.
If you have any questions, I suggest that you take the CEU course. Apparently, I may not be the best person to answer Coumadin questions. But feel free to leave comments below.