Case Studies

OCTOBER 12, 2011
Craig I. Coleman, PharmD, and Hyejin Kim, PharmD Candidate

Case One

Hypoglycemia and Beta-Blockers 

OP is a 61-year-old man who visits your clinic for a regularly scheduled follow-up visit. He has hypertension and type 2 diabetes mellitus, and is currently taking metformin 1000 mg twice daily, glipizide 10 mg once daily, and metoprolol XL 100 mg once daily. OP states that he is adherent to his medications, but does not check his blood glucose regularly. He has recently noticed that he sometimes breaks out in sweats between meals. He is wondering whether this is something to be concerned about, because he has no other symptoms. 

How do you, as the pharmacist, respond?


Case Two

“No-Flush” Niacin 

AC is a 53-year-old woman who comes to the pharmacy counter looking for an OTC niacin product. She tells the pharmacist that she is currently taking atorvastatin 40 mg once daily, and that her doctor instructed her to buy niacin and take 1 tablet once daily to further lower her “bad cholesterol.” She has heard that flushing is a common side effect of the medication, and says that she would prefer the “no-flush” niacin. Her next appointment with the doctor is in 4 weeks. 

How should the pharmacist counsel AC? 



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 from the University of Connecticut School of Pharmacy. 


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