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website. Quick, let's get on with it. I want to talk for a minute about the interaction between acedaminifin and warfarin.

This is, I think, maybe one of the most dangerous drug interactions out there because

acetaminin is everywhere.

And I think a lot of us aren't familiar with this interaction.

I was a pharmacist

for five years. And I thought nothing about telling people just to take a, I knew they shouldn't

take aspirin with warfarin or ibuprofen with warfarin. I have no problem saying, go ahead and take

and take acetymenifin. But I wonder how many people were harmed by that advice. Okay, so now imagine that you're seeing your, I don't know, 20th patient of the day, and they're on warfarin, and you get a lab back in the INR is 6.5.

And the patient is adamant that not only was the INR 2.5, you know, two weeks ago, but she hasn't changed her dose at all. And why might

it be that the INR is so much higher than intended? And one thing that we, we don't talk about

often enough is the potential for acedaminathan or paracetamol, depending where you work, to

potentiate the effects of warfarin. This is, I think, one of the most dangerous drug

interactions out there because most people have never heard of it or they have some sort of

passing awareness of it, but acetaminophon is just ubiquitous. And so what's this interaction

all about? This is a complicated one. And so what's this interaction all about? This is a complicated

one. And so to understand this interaction requires understanding exactly how warfarin works.

When you have a patient on warfarin and their INR is 2.5, it's because warfarin has interfered with

the vitamin K cycle.

I'm going to walk you through this.

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