Long-Term Care Survey Alert
Get Dietary Involved When Patients Are Taking Coumadin
Eating more or less of certain foods can affect cogulation. Aagulant effect of Coumadin, which means people taking the blood thinner need to watch their diet. Key point: Changing daily meals and snacks/supplementation can have a major effect on vitamin K levels and hence INRs, says Tom Snader, PharmD, CPG, a consultant in North Wales, Pa. Many green vegetables, such as spinach, peas, Brussels sprouts, kale, and broccoli, have significant amounts of vitamin K in them. So does Boost, the nutritional supplement, and green tea. Resource: For a comprehensive list of foods with high, medium and low vitamin K content, go to www.ptinr.com/docs/Vit_K_registry.pdf. The person on Coumadin should maintain a consistent dietary intake of vitamin K and avoid "wide swings," advises Linda Young, MS, RD, LMNT, an assistant professor of practice at the University of Nebraska-Lincoln. "Patients and their families should also receive instructions at discharge from the nursing facility about this dietary issue," Young tells Eli. Otherwise, a person might eat more fresh vitamin-K rich produce in the summer, for example, when it's more readily available, she cautions. Good idea: Also ask the resident's family or visitors to check with you before bringing the person snacks or meals or before they take the resident out on a therapeutic leave of absence. Discharge teaching tip: Remind residents on Coumadin and their families to check with their physician after discharge before taking any medication, including aspirin, or over-the-counter supplements. In addition to vitamin K, supplements that can interact with warfarin, according to Mayoclinic.com, include: • Fish oil and omega-3 supplements • Bromelains • Coenzyme Q10 (ubidecarenone) • Cranberry extracts • Danshen • Dong quai • Garlic • Ginkgo • Ginseng • St. John's wort Resource: Check out a cookbook with recipes for patients on Coumadin: www.coumadincookbook.com/
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