Case Studies

FEBRUARY 14, 2010
Craig I. Coleman, PharmD and Diana M. Sobieraj, 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. Dr. Sobieraj is a senior scientist at the University of Connecticut/Hartford Hospital Evidence-Based Practice Center.


Multiple Sclerosis

AP, a 33-year-old woman recently diagnosed with relapsing-remitting multiple sclerosis (RRMS) comes to the pharmacy counter with her first prescription for interferon beta-1b (Betaseron) 0.25 mg subcutaneously every other day. The diagnosis of RRMS was made a few weeks prior, after AP began complaining of bouts of changes in sensation, muscle weakness, fatigue, and unsteadiness on her feet. At present, AP clearly looks overwhelmed by her recent diagnosis and appears apprehensive about taking this new medication. What counseling should the pharmacist provide to AP as a patient new to interferon treatment?



LM, an 18-year-old woman who has suffered from acne for the past 2 years, comes to the pharmacy. In the past, the pharmacist has helped her in the selection of several different OTC products; however, LM has had little success. LM appears to have 10 to 20 lesions located around her jaw line and chin with several lesions appearing erythematous and pustular. She has no involvement of her chest, back, or shoulders. Recently, LM went to see a dermatologist who diagnosed her with moderate acne and gave her 2 prescriptions: adapalene (Differin) 0.1% cream to be applied to the affected area at bedtime and clindamycin (Cleocin-T) 1% lotion to be applied to the affected area daily. She was instructed by the dermatologist to use each product after cleansing her skin and to return in 2 months for a follow-up appointment. When picking up her prescriptions, LM asks the pharmacist, “Why do I need 2 medications for my acne—shouldn’t I just try one to start?” How should the pharmacist respond?

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