July 2003: Case Study 1

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KC?s grandmother enters the pharmacy excitedly. She approaches the counter and asks to speak with KC, the pharmacist. She tells KC that she heard from the "girls at my bridge game" that a new product is available for the treatment of overactive bladder. The "girls" told her that it was in the form of a patch. She wants to know whether she should ask her physician to write a prescription for her.

KC knows that her grandmother is frustrated by her overactive bladder problems. She is also embarrassed by her need to wear protective undergarments. The only medication covered by her grandmother?s insurance plan is generic oxy-butynin. Unfortunately, her doctor has determined that oxybu-tynin is not an appropriate therapy for her due to her uncontrolled narrow-angle glaucoma. Due to her limited income, she is unable to afford any medications that are not covered by her insurance plan.

If her grandmother?s insurance plan covers this new patch, is this an appropriate alternative for her?

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Unfortunately, the new patch contains oxybutynin. Although this patch will provide the ease of twice-weekly patch changes and reduced side effects, it should not be used in patients with urinary retention, gastric retention, or uncontrolled narrow-angle glaucoma.