00:00:00
hi i was told you're here to pick up
00:00:01
your medication my name is olivia and
00:00:02
i'm a pharmacist here hi
00:00:04
so i just wanted to verify uh your name
00:00:06
and date of birth is this correct
00:00:08
jim clark 12 3 1955. that's me
00:00:11
perfect and today you are picking up
00:00:13
warfarin uh does that sound correct
00:00:15
sure okay what did the doctor tell you
00:00:17
about this medication
00:00:18
um he told me that it was for my heart
00:00:20
um probably a few other things but i
00:00:22
don't really remember
00:00:23
okay so this is there is a lot um about
00:00:25
this medication do you have a couple
00:00:26
minutes for us to discuss i just want to
00:00:28
make sure you're taking it safely and
00:00:29
effectively
00:00:30
yeah sure okay good deal so this
00:00:32
medication is called warfarin
00:00:33
it also goes by the name coumadin your
00:00:35
doctor prescribed you five milligrams
00:00:37
for which you will take
00:00:38
every day preferably at the same time of
00:00:40
the day
00:00:41
you do have three refills with this
00:00:43
medication
00:00:45
and if you look at these tablets they're
00:00:46
a peach orangish color
00:00:48
and that's indicative of the dose with
00:00:49
this medication specifically
00:00:51
different doses come in different colors
00:00:53
so you're just going to want to make
00:00:54
sure that
00:00:54
the tablets that you are taking are this
00:00:56
peach orangish color okay
00:00:58
and so um like you said this medication
00:01:01
is for your
00:01:02
atrial fibrillation which is where the
00:01:04
heart has
00:01:05
a varying rhythm and what that can do is
00:01:08
form a clot
00:01:09
which can then um go to your head which
00:01:11
we do not want
00:01:12
um this medication is to help prevent
00:01:14
that um but just so that you're aware
00:01:16
some signs of
00:01:17
a stroke if that does happen are just
00:01:19
facial droopiness
00:01:20
um your arms can also go down a little
00:01:22
bit if you stick them out
00:01:24
um if you notice this or someone else
00:01:26
notices it is an emergency
00:01:28
and you'll want to call 9-1-1 and with
00:01:30
that being said
00:01:31
you just don't want to miss a dose with
00:01:32
this medication it's very important
00:01:34
that you don't miss a dose and so like i
00:01:36
said it's taken every day
00:01:38
so if you come up if you remember that
00:01:40
same day you can go ahead and take it
00:01:41
but if you're getting too close to your
00:01:43
second dose you're not going to want
00:01:44
to stack the medication just wait until
00:01:46
your next dose and the next time
00:01:48
um contact your provider um something
00:01:51
else that can be super helpful with this
00:01:52
medication is to take a log so
00:01:54
all of your appointments all of your
00:01:55
labs which we'll talk about in a minute
00:01:57
when you took it if there's any
00:01:58
deviations from treatment
00:02:00
and that can help optimize your
00:02:03
therapy with warfarin okay you can do
00:02:05
that so
00:02:06
yeah and i see here
00:02:09
on uh your your list you're taking
00:02:12
ibuprofen is that correct
00:02:14
i am it's um for my arthritis pain okay
00:02:17
um that does interact with warfarin this
00:02:19
medication is very sensitive in the fact
00:02:21
that
00:02:22
diet um other medications uh can
00:02:25
interact with it and
00:02:26
and change how it is supposed to work
00:02:28
and so uh one of the things
00:02:30
um so the ibuprofen you're going to want
00:02:32
to stop
00:02:34
yeah so something else that we can put
00:02:35
in its place is tylenol or it's also
00:02:36
known as acetaminophen it is over the
00:02:38
counter
00:02:39
uh but you can also take that for your
00:02:41
um
00:02:42
you can take that for your arthritis
00:02:44
pain okay so one of the things that
00:02:46
you'll note
00:02:47
um i did receive from your provider that
00:02:48
you have an appointment coming up do you
00:02:49
recall that
00:02:50
um yeah i think it's in three three days
00:02:53
yes okay yeah
00:02:54
follow up with the doctor yeah so what
00:02:56
they're one of the things that they're
00:02:57
gonna be checking is called inr
00:02:59
it's it's a blood draw for which they
00:03:00
draw the labs the inr
00:03:02
is a number that's given in regards to
00:03:05
how quickly
00:03:05
your blood clots and your goal for the
00:03:09
uh for the afib is going to be 2.2 to 3
00:03:12
and so that's going to be kind of your
00:03:13
happy place and you will have more lab
00:03:15
draws and probably more doctor visits at
00:03:16
the start until they can
00:03:18
kind of even you out with the correct
00:03:19
dosage for the medication
00:03:21
um but but that's that's what your next
00:03:24
doctor appointment is more than likely
00:03:26
for
00:03:26
okay yeah so that was kind of a lot do
00:03:29
you have any questions for me up to this
00:03:30
point
00:03:31
do you know how long i'm gonna have to
00:03:33
take this medicine for
00:03:34
yeah so this is like taking a lot of
00:03:36
medicine so i totally understand
00:03:38
this is a long-term therapy medication
00:03:41
um because of your afib
00:03:42
so you will want to on top of not
00:03:44
missing a dose you're going to want to
00:03:45
make sure that you take this
00:03:46
continuously and don't abruptly stop it
00:03:48
um it can result in uh it can result in
00:03:52
clots and things like that which you
00:03:54
don't want but i totally understand not
00:03:56
wanting to take the medication but this
00:03:57
is one that you're definitely going to
00:03:58
want to have on board this is going to
00:03:59
help you is that important
00:04:00
yeah this is a really important one and
00:04:03
like i said there are a lot of
00:04:04
interactions with it so any medications
00:04:06
whether that be prescription
00:04:07
over-the-counter herbal supplements
00:04:09
you're going to want to make sure to
00:04:10
talk with either myself a pharmacist
00:04:11
here or your provider before starting
00:04:13
those
00:04:14
just to run an interaction check because
00:04:15
there is so many with this medication
00:04:17
okay but there are good outcomes with
00:04:20
people with warfarin so
00:04:21
we just want to make sure to keep you on
00:04:23
board with that
00:04:24
yeah all right so a couple things to
00:04:26
note like i said is
00:04:29
this medication can work differently
00:04:31
based on
00:04:32
um diet and other medications diets
00:04:34
specifically it has to do with vitamin k
00:04:37
so our body does not make vitamin k and
00:04:39
so all of the vitamins take
00:04:40
the vitamin k intake that we control can
00:04:44
alter the medication and so you'll see
00:04:46
here and this handout is for you that
00:04:47
you can take home with you
00:04:48
this uh this list of foods here are ones
00:04:51
that are rich in
00:04:52
vitamin k so those are your greens your
00:04:53
broccoli kale lettuce i want to
00:04:56
reiterate that
00:04:57
it's not that you need to avoid these
00:04:59
because they are healthy foods for you
00:05:00
it's just a matter of maintaining
00:05:01
consistency
00:05:02
with how you take them and so that'll
00:05:06
help maintain your vitamin k levels
00:05:08
um which will keep your inrs which is
00:05:10
the lab that they'll test for that'll
00:05:12
kind of keep that consistent
00:05:14
okay and then additionally um also
00:05:17
another reiteration you just want to
00:05:18
make sure that any new medications you
00:05:20
start
00:05:20
you want to notify your your doctors
00:05:23
before you start taking them
00:05:25
additionally any appointments you go to
00:05:26
so like let's say the dentist
00:05:28
you'll want to make sure to tell them
00:05:29
that you're on warfarin oh okay yeah
00:05:31
and also like they do have like medicine
00:05:32
bracelets or little cards that you can
00:05:34
keep in your wallet
00:05:35
um which of course we don't want this to
00:05:37
happen but if any case you were an
00:05:38
emergency and
00:05:39
first responders had to respond um they
00:05:41
would want to know that you're on
00:05:42
warfarin okay
00:05:43
yeah so some side effects to look out
00:05:46
for with this medication
00:05:47
um are bleeding uh so if you see
00:05:51
uh if you're brushing your teeth and you
00:05:52
kind of see something there or no
00:05:54
sleeves you also want to
00:05:55
do sole checks uh to make sure that you
00:05:58
don't see any light or dark
00:05:59
blood um it'll just look kind of dark
00:06:01
and tarry so just check
00:06:02
that also if for some reason you vomit
00:06:05
and you see coffee ground
00:06:07
type um substance in your moment you're
00:06:09
going to want to make sure to notify
00:06:10
your health care provider
00:06:11
and if you're feeling bad go to the
00:06:13
emergency room so
00:06:14
because we want to make sure that um
00:06:16
this medication is doing its job but
00:06:18
it's not doing it too well
00:06:19
so you'll want to make sure of that also
00:06:22
these are
00:06:22
this is a rare occurrence but it's
00:06:24
called purple toe
00:06:26
um so any skin changes or disc or
00:06:28
discoloration that you see
00:06:30
um mainly in the per in the legs
00:06:33
or um you know arms or fingers or
00:06:35
anything or toes
00:06:36
just make sure you notify your provider
00:06:38
so do you have any questions for me
00:06:41
um no i think
00:06:44
this has a lot of the information right
00:06:47
yeah yeah
00:06:48
no no i think i got it uh the food
00:06:51
can't take my ibuprofen got to use the
00:06:53
uh the acetaminophen instead
00:06:56
yeah so the acetaminophen you're not
00:06:57
going to want to take uh you're not
00:06:59
going to take it
00:07:00
um you know too frequently um two grams
00:07:02
a day of that is is
00:07:04
is where you want to kind of cap off and
00:07:06
if you are still having arthritic pain
00:07:07
um we can talk to your provider about
00:07:09
what to do from there okay all right
00:07:11
yep and then so the diet and then the
00:07:13
medications this is a list of
00:07:14
medications
00:07:15
um that you'll want to stray away from
00:07:16
that includes aspirin and
00:07:18
any nsaid so naproxen or ibuprofen
00:07:21
you're going to want to stay away from
00:07:22
that
00:07:22
and like i said what you have currently
00:07:24
on your list right now is good to go
00:07:26
um but you just want to make sure
00:07:28
anything new that you add
00:07:29
um gotta talk to them first yeah you're
00:07:31
gonna want to talk to your provider and
00:07:32
then kind of keep your food intake
00:07:33
consistent
00:07:34
um as well so okay i know i think i've
00:07:37
got it
00:07:38
okay can you repeat back to me just a
00:07:39
couple of high points that we talked
00:07:40
about so i don't understand
00:07:42
um don't miss any doses um if i do
00:07:45
use my log to note it down um
00:07:49
the diet as far as uh keeping it
00:07:51
consistent
00:07:53
don't really change it up a bunch uh i
00:07:55
can't yeah again can't use my ibuprofen
00:07:57
but we'll try that acetaminophen
00:07:58
um uh yeah
00:08:01
okay that sounds good and you do have so
00:08:04
right now you do have 30 pills in here
00:08:06
you do have three refills so once you
00:08:08
start getting low to around four to five
00:08:10
pills just give me a call
00:08:11
you are going to want to store this away
00:08:13
from kids away from pets
00:08:15
this is um an unsafe medication if it
00:08:18
gets
00:08:18
in the hands of people that it's not
00:08:19
supposed to be in so you're just going
00:08:21
to want to make sure to kind of keep
00:08:22
this in an inconspicuous place
00:08:24
and i can do that all right that sounds
00:08:26
good and if you have any questions
00:08:28
please feel free to give me a call
00:08:30
yeah any questions you have or anything
00:08:32
new um let us know and uh
00:08:34
we'll see you then okay all right thank
00:08:36
you so much
