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We describe a year-old Haitian man who had been taking warfarin for 5 years for atrial fibrillation and pulmonary hypertension. Prior to the interaction, his INR was therapeutic for 5 months while taking warfarin
Heart rhythm is irregularly irregular. On exam abdomen is soft, non-tender. Currently denies vomiting, fever, URI sx; no signs of blood in stool. Patient continues to complain of RLQ cramps; on exam is nontender. No evidence for left heart decompensation, no clear sign of pneumonia, although left lower lobe is crowded by enlarged heart. Diagnosis is hemopericardium likely secondary to spontaneous bleed given supratherapeutic INR.
It is used to treat constipation and also to clear the bowel before diagnostic tests such as colonoscopy. Senna is also used for irritable bowel syndrome IBS, hemorrhoids, and weight loss. Senna fruit seems to be gentler than senna leaf. The AHPA recommends that senna leaf products be labeled, Do not use this product if you have abdominal pain or diarrhea. Consult a healthcare provider prior to use if you are pregnant or nursing. Discontinue use in the event of diarrhea or watery stools. Do not exceed recommended dose. Senna is effective as a laxative for constipation.
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Teri Klein, Russ Altman and colleagues did the most comprehensive genetic analysis ever to determine how people would respond to different doses of the blood thinner, warfarin. Your DNA affects your hair color, your blood type and even how you react to some medications.
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