{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:54:39Z","timestamp":1790315679077,"version":"4.1.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T00:00:00Z","timestamp":1726704000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>Purpose: To describe a case of significantly increased warfarin requirements in a patient receiving rifampin for the management of tuberculosis. Summary: A 76-year-old male was admitted due to altered mentation, cough, and weight loss. He was diagnosed concurrently with tuberculosis and a pulmonary embolism. Given the profound effect of rifampin on CYP450 enzymes, direct oral anticoagulants were avoided and warfarin therapy was selected. Management was further complicated by a gastrointestinal bleed during admission, history of cancer, and low body weight. After several weeks of daily international normalized ratio monitoring, a stable regimen of 14\u00a0mg of warfarin daily was established, allowing for the patient\u2019s safe discharge. Practice Implications: This report underscores the significance of tailored treatment plans, vigilant monitoring, and interdisciplinary collaboration which are necessary to navigate the complexities associated with these medications and optimize patient outcomes.<\/jats:p>","DOI":"10.1177\/08971900241285226","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T18:41:27Z","timestamp":1726771287000},"page":"270-274","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Very High Warfarin Dosing Requirements in a Patient With Tuberculosis and a Pulmonary Embolism: A Case Report"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6291-5561","authenticated-orcid":false,"given":"Marcus","family":"Mize","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Cape Fear Valley Medical Center, Fayetteville, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3609-8076","authenticated-orcid":false,"given":"Carrie","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Campbell University College of Pharmacy and Health Sciences, Buies Creek, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6889-0156","authenticated-orcid":false,"given":"Riley D.","family":"Bowers","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Campbell University College of Pharmacy and Health Sciences, Buies Creek, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,19]]},"reference":[{"key":"bibr1-08971900241285226","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2021.07.055"},{"key":"bibr2-08971900241285226","volume-title":"StatPearls [Internet]","author":"Patel S","year":"2023"},{"issue":"5","key":"bibr3-08971900241285226","first-page":"295","volume":"95","author":"Wilbur J","year":"2017","journal-title":"Current Therapy. American Family Physician"},{"key":"bibr4-08971900241285226","volume-title":"StatPearls [Internet]","author":"Beloor SA","year":"2023"},{"key":"bibr5-08971900241285226","volume-title":"StatPearls [Internet]","author":"O'Connor C","year":"2024"},{"key":"bibr6-08971900241285226","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw566"},{"key":"bibr7-08971900241285226","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.12.068"},{"key":"bibr8-08971900241285226","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-020-03057-x"},{"key":"bibr9-08971900241285226","first-page":"415","volume":"15","author":"Mar PL","year":"2022","journal-title":"Circulation"},{"key":"bibr10-08971900241285226","unstructured":"Warfarin Collaborative Practice Dosing Protocol.\n                      University of Connecticut Health\n                      . 2015. https:\/\/health.uconn.edu\/pharmacy\/wp-content\/uploads\/sites\/60\/2016\/03\/warfarin_collaborative_practice_dosing_protocol.pdf. Accessed 23 May 2024."},{"key":"bibr11-08971900241285226","unstructured":"Rose A, Hoch J, Kumfer K, et al. Warfarin Management - Adult \u2013 Inpatient Consensus Care Guideline\n                      . UWHealth\n                      .\n                      2021. https:\/\/www.uwhealth.org\/cckm\/cpg\/hematology-and-coagulation\/related\/Warfarin-Management-Adult-Inpatient-Consensus-Care-Guideline-5-2021.pdf. Accessed 23 May 2024."},{"key":"bibr12-08971900241285226","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2089"},{"key":"bibr13-08971900241285226","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v24.i26.2806"},{"key":"bibr14-08971900241285226","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1302507"},{"key":"bibr15-08971900241285226","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1113572"}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900241285226","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08971900241285226","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900241285226","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:33:41Z","timestamp":1777509221000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08971900241285226"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,19]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1177\/08971900241285226"],"URL":"https:\/\/doi.org\/10.1177\/08971900241285226","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,19]]}}}