DC, a pharmacy student currently on an infectious disease rotation, is asked to review the laboratory reports for the clinic patients. The 5 patients seen in the clinic today are infected with the hepatitis C virus and are receiving treatment with peginterferon alfa-2b and ribavirin. The unusual lab values for these 5 patients include the following:
Patient 1 Hgb 9.5 g/dL
Patient 2 Hgb 8.0 g/dL
Patient 3 WBC 1.4 x 109/L
Patient 4 Platelets 70 x 109/L
Patient 5 Platelets 40 x 109/L
The attending physician explains to DC that peginterferon and ribavirin must be dose-modified or discontinued based on hemoglobin, WBC (white blood count), neutrophil, and platelet values. He then asks DC to make recommendations pertaining to the patients? peginterferon and ribavirin.
What recommendations should DC make pertaining to each patient?s therapy?