A patient who is prescribed warfarin for a cardiovascular condition mentions during the interview process that they have recently started taking an herbal supplement to improve their cardiovascular health. Select the supplement that may potentiate the effects of warfarin and increase the risk of bleeding.
Ginseng
Dong Quai
St. John's Wort
Ginkgo Biloba
Dong Quai (Angelica sinensis) is an herb that has anticoagulant properties similar to warfarin and may enhance the anticoagulant effect of warfarin, which can significantly increase the risk of bleeding. Hence, patients on warfarin should be advised to avoid Dong Quai.
St. John's Wort is known to interact with a wide range of medications, which can result in decreased effectiveness of other drugs, rather than potentiating warfarin.
Ginkgo Biloba, while having some blood-thinning effects, are not as strongly linked to interactions that would increase warfarin activity to dangerous levels.
Ginseng has been noted to decrease the effectiveness of warfarin, not potentiate its effects.
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