/publications/issue/2013/June2013/Case-Studies-0613

Case Studies

Author: Yunfeng Zhu, PharmD Candidate, Diana M. Sobieraj, PharmD, and Craig I. Coleman, PharmD

Case 1
CS, a 77-year-old man recently diagnosed with atrial fibrillation, presents to your pharmacy with a new prescription for dabigatran etexilate 150 mg twice daily. His past medical history is significant for hypertension and type 2 diabetes (and therefore has a CHADS2 score of 3). He is currently taking metoprolol, lisinopril, and metformin. Upon talking with CS you find out that he uses a pillbox to manage his medications.
As CS’s pharmacist, what important counseling point regarding his dabigatran should you offer?
 
Case 2
PH, a 33-year-old woman, presents to your healthcare clinic with a 10-year history of worsening plaque psoriasis currently affecting 15% of her body. The psoriatic plaques are found on both her trunk and extremities. She has tried a variety of topical steroids and a topical vitamin D analog as well as PUVA and NB-UVB phototherapy treatment in the last 3 years, none of which optimally controlled her psoriasis. She has a history of obesity and was recently diagnosed with hypertension for which olmesartan 20 mg daily was prescribed. Her physician asks for your input on which therapy PH should try next for her psoriasis.
How do you, the pharmacist, respond to PH’s physician?