Case Studies

NOVEMBER 16, 2011
Craig I. Coleman, PharmD, and Hyejin Kim, PharmD Candidate

Case One 

Oral Contraceptives and Smoking 

QS is a 38-year-old woman who comes into the clinic requesting a prescription for oral contraception (OC). The physician asks you, the pharmacist, what product you would recommend for her. Upon further inquiry, QS states that she does not have any medical problems or a family history of venous thromboembolism. However, she reports currently smoking 16 to 20 cigarettes per day. Previously, QS was smoking up to 2 packs of cigarettes daily, but in the last month she has started chewing approximately 8 pieces of 4-mg nicotine gum per day to help her cut down.

What is the appropriate recommendation for QS?


Case Two 

Toxoplasmosis and TMP-SMX Allergy

JK is a 35-year-old man who is HIV positive. For his antiretroviral therapy, he is taking Atripla (efavirenz/emtricitabine/ tenofovir) once daily. Recently, JK’s immunoglobulin G titer for Toxoplasma gondii was found to be positive, and his CD4 count was 82. It is determined that he should be given prophylaxis for toxoplasmosis. However, he has a known allergy to trimethoprim/sulfamethoxazole (TMP-SMX). 

What prophylactic regimen can you give instead? 


Dr. Coleman is associate professor of pharmacy practice and director of the pharmacoeconomics and outcomes studies group at the University of Connecticut School of Pharmacy. Ms. Kim is a PharmD candidate at the University of Connecticut School of Pharmacy.

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