Hypertension in Medicine / Internal Medicine — 60yo Man | Infectious Diseases | SMLE Q#18227
SMLE Question #18227
Medicine / Internal Medicine
Infectious Diseases
Objective: OBJ-001
Last updated: February 2026
A 60-year-old man with hypertension and a mechanical aortic valve takes lisinopril, amlodipine, and warfarin (target INR 2.5–3.5). He is admitted with 3 weeks of productive cough, weight loss, night sweats, and dyspnea. He is started on rifampicin, isoniazid, pyrazinamide, and ethambutol. Two days later, his INR is 1.4 (previously stable around 3.0). Which medication needs to be adjusted to maintain therapeutic anticoagulation?
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