MPharm Posology Case 4 by kannan https://padlet.com/marikannan/3ia74x0h46ak en-us 2015-12-18 02:17:40 UTC 2026-03-01 11:42:55 UTC hello@padlet.com Warfarin + Sodium Valproate https://padlet.com/marikannan/3ia74x0h46ak/wish/87013030 Sodium valproate displace warfarin from plasma protein binding thus increasing the concentration of free warfarin and enhancing the warfarin effect

- 99% bound primarily to albumin (warfarin)

]]> 2015-12-18 08:06:09 UTC https://padlet.com/marikannan/3ia74x0h46ak/wish/87013030 a)  The most likely problem drug is sodium valproate since this drug is recently prescribed to control the epilepsy. It has interaction with the warfarin that Annie has been taking-ncrease the risk of bleeding.  marikannan https://padlet.com/marikannan/3ia74x0h46ak/wish/87013125 2015-12-18 08:07:30 UTC https://padlet.com/marikannan/3ia74x0h46ak/wish/87013125 b) The interaction occuring is the drug-drug interaction between sodium valproate and warfarin -PK interaction particularly at the distribution phase as sodium valproate displaces warfarin from its binding site.   marikannan https://padlet.com/marikannan/3ia74x0h46ak/wish/87013148 This is a serious problem as more anticoagulant effect of warfarin will take place. Higher chance of internal bleeding

]]> 2015-12-18 08:07:44 UTC https://padlet.com/marikannan/3ia74x0h46ak/wish/87013148  Evidence for mechanism of interaction https://padlet.com/marikannan/3ia74x0h46ak/wish/87013287 2015-12-18 08:09:48 UTC https://padlet.com/marikannan/3ia74x0h46ak/wish/87013287 https://padlet.com/marikannan/3ia74x0h46ak/wish/87013356 NICE Guideline for Epilepsy

]]> 2015-12-18 08:10:33 UTC https://padlet.com/marikannan/3ia74x0h46ak/wish/87013356 C) Suggest change of sodium valproate to levetiracetam. It is licensed for monotherapy of focal seizures. It has less side effect of skin rash and is not likely to interact with warfarin. Suggested dose is 250mg OD for 1-2 weeks, then BD.  https://padlet.com/marikannan/3ia74x0h46ak/wish/87014008 2015-12-18 08:20:07 UTC https://padlet.com/marikannan/3ia74x0h46ak/wish/87014008 https://padlet.com/marikannan/3ia74x0h46ak/wish/87014692 Evidence for mechanism (Stockley's Drug Interactions)

]]> 2015-12-18 08:28:12 UTC https://padlet.com/marikannan/3ia74x0h46ak/wish/87014692