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Digoxin toxicity — GPhC CRA MCQ

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HardCardiovascular TherapeuticsDigoxin toxicityGPhC CRA

A 76-year-old taking warfarin for atrial fibrillation is started on amiodarone. His INR was 2.6 yesterday and the amiodarone prescription is clinically appropriate. What is the most appropriate pharmacy plan?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Continue both with earlier INR monitoring and anticoagulant review

Amiodarone can increase warfarin exposure and the INR, but the interaction develops over time and does not usually require abrupt cessation of indicated anticoagulation. The anticoagulation service or prescriber should be informed, with earlier and more frequent INR monitoring and individualised warfarin adjustment. Dose spacing does not prevent this metabolic interaction.

Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment