Case Studies

Author: Craig I. Coleman, PharmD


Dr. Coleman is an assistant professor of pharmacy practice and director of the pharmacoeconomics and outcomes studies group at the University of Connecticut School of Pharmacy.


 

Iron Deficiency Anemia

 

A 48-year-old woman presents to an ambulatory care clinic complaining of weakness, headache, and mild fatigue. Her physician diagnoses her with a mild case of iron deficiency anemia due to poor diet and decides to initiate oral iron replacement. He sees the pharmacist on duty and asks for advice about which formulation of oral iron to use. The physician notes, “I have been using a ferrous gluconate tablet 3 times daily in my patients because this preparation seems to cause less stomach upset, but I do not always get the results I want.”

What advice can the pharmacist provide to the physician?


 

Nonerosive Reflux Disease

PI comes to the pharmacy with a prescription for lansoprazole (Prevacid) 30 mg once daily. PI tells the pharmacist that about 5 months ago, he started taking lansoprazole for mild heartburn (without esophagitis) with good response. PI notes that after 3 months, his physician let him stop “because he did not like taking pills every day.” Last week his heartburn symptoms returned, however, and his physician gave him this new prescription for lansoprazole. PI asks, “How long will I have to take these pills this time?”

How should the pharmacist respond?