Case Studies

DECEMBER 28, 2009
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.





CASE ONE

Diabetes Prevention


During his yearly physical, IR, a 42-year-old Caucasian man, is found to have a blood glucose of 122 mg/dL following an overnight fast. IR is instructed to exercise more (30 min/ day) and lose weight; but despite these attempts at lifestyle modification, he is found to have a fasting glucose of 119 mg/ dL at a 3-month follow-up visit. IR undergoes an oral glucose tolerance test, and his 2-hour postload glucose is discovered to be 212 mg/dL. Currently, IR is taking amlodipine 10 mg once daily for hypertension and atorvastatin 20 mg daily for hyperlipidemia. He has an immediate family history of diabetes (his mother). Are there any pharmacologic treatments that should be considered for IR?


CASE TWO

Dronedarone


QT, a 58-year-old African American woman, comes to the pharmacy with a new prescription. Before handing it to the pharmacist, QT explains that she was recently admitted to the hospital because she fainted due to a rapid and irregular heartbeat. She further explains that after the doctors got her heart beating normally, one of the younger ones told her to take this medication to prevent the abnormal heartbeat from happening again. The pharmacist is handed the prescription and sees that it is written for “Multaq 400 mg twice daily for atrial fibrillation #180.” Upon review of QT’s medication profile, the pharmacist discovers that the patient is also taking lisinopril 20 mg once daily, carvedilol 25 mg twice daily, spironolactone 25 mg once daily, and atorvastatin 80 mg daily. Should the pharmacist fill this prescription?







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