Case Studies

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.

Gout

GA is a 52-year-old man who limps into your pharmacy and hands the pharmacist a prescription for probenecid. GA has a past medical history significant for gout and a heart attack 3 years ago and takes metoprolol, atorvastatin, and aspirin. While entering the patient's insurance information into the computer, the pharmacist strikes up a conversation with GA about what he did last weekend. GA tells the pharmacist that he threw a big 40th birthday party for his wife and that he "had a few too many drinks." He then tells the pharmacist that the next day his gout flared up, resulting in a painfully inflamed big toe. At just that moment, the pharmacist realizes that the probenecid prescription is a few months old. Upon further questioning, GA admits to the pharmacist that this probenecid prescription was given to him along with a prescription for colchicine by his physician 2 months ago. He filled the colchicine prescription at that time and used it until his gouty attack subsided, but did not have the probenecid prescription filled. He thought he would save himself a trip to the physician and just take the probenecid to treat this attack.

Should the pharmacist fill this prescription?

Ringworm Infection

RW is a 32-year-old woman who comes to the pharmacy counter to ask the pharmacist for his advice. She tells the pharmacist that she has a ringworm (tinea) infection and wants to purchase a suitable OTC, topical antifungal agent to treat it. RW is otherwise healthy and takes no other prescription or OTC medications.

How should the pharmacist respond?