Thomas Adeyemi
High · 54Tom · 63M · DOB 17 May 1963 · MRN RN-62844
COPD GOLD D after a steroid-treated exacerbation. AF on warfarin, and untreated steroid-related bone risk.
Allergies: Aspirin (wheeze)
For full active treatment
INR 3.4 on prednisolone
Steroids potentiate warfarin. Recheck before the weekend.
Repeated oral steroids, no bone protection
NICE: consider bone protection after recurrent courses.
Aspirin allergy
Do not use dual antiplatelet or NSAID analgesia.
Clinical parameters
INR
3.4
Ref 2.0–3.0
Eosinophils
0.32×10⁹/L
Ref 0.0–0.4
CRP
18mg/L
Ref <5
Organ risk
Conditions
COPD GOLD D
FEV1 42% · 2 exacerbations/year
Atrial fibrillation
Osteoporosis risk
Repeated oral steroids
Ex-smoker
40 pack years · quit 2019
Care team
Dr Fiona Bell
Respiratory
Dr Amara Okonkwo
Clinical pharmacology
Luis Romero
Pulmonary rehab
Next encounter
INR recheck
Wed 23 Sep · 16:00
Anticoagulation desk · Anticoag clinic