Case Studies

Author:

Case One

You are a community pharmacist filling a new prescription for the antiepileptic drug (AED) phenytoin 300 mg/day. The computer system prompts you with a warning of a severe interaction between phenytoin and lopinavir/ritonavir. The warning states that concurrent use of these 2 drugs may result in decreased lopinavir exposure. You verify with the patient that they are indeed taking this antiretroviral (ARV) at a dose of 400 mg/100 mg once daily.

What recommendation do you have for the physician regarding the ARV dose and the patient’s AED regimen?


Case Two

CM approaches the community pharmacist at the counseling window. She says that she recently picked up medication that is making her “feel very uncomfort- able and restless,” as though she has to be constantly moving. CM states that she is probably going to stop taking her medication. The pharmacist reviews her medication history and finds that she picked up prescriptions for bupropion XL 300 mg and Abilify 20 mg, which was an increase from her previous 10-mg dose.

What drug-induced movement disorder is CM experiencing? How can it be managed?


Dr. Coleman is associate professor of pharmacy practice and director of the pharmacoeconomics and outcomes studies group at the University of Connecticut School of Pharmacy. Ms. Oliveira is a PharmD candidate from the University of Connecticut School of Pharmacy.