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Case Studies

Craig I. Coleman, PharmD, and Jonathan T. Caranfa, PharmD Candidate
Published Online: Monday, March 19, 2012   [ Request Print ]

 

Case one 

GB is a 42-year-old man who comes to the clinic for a scheduled visit. GB is overweight and admits to exercising very infrequently. He has a medical history of hypertension and hyperlipidemia for which he takes hydrochlorothiazide and rosuvastatin, respectively. Recent laboratory results show GB has a fasting blood glucose of 172 mg/dL, an A1C of 7.6%, and a serum creatinine of 1.1 mg/dL. He does not complain of polyuria, polydipsia, or other common signs of diabetes. Following repeat laboratory results a few weeks later showing similar glucose abnormalities, GB’s physician diagnoses him with type 2 diabetes and decides to initiate pharmacologic treatment. 

What is the most appropriate initial pharmacologic treatment for GB?
 

Case Two

 

CK is a 23-year-old woman who presents to her physician with a positive result (15 mm induration) on her purified protein derivative (PPD) tuberculin skin test. She denies signs or symptoms such as cough, blood-tinged sputum, fever, or weight loss, and her chest x-ray is unremarkable. CK’s physician diagnoses her with latent tuberculosis (TB). CK states she is enrolled in classes at a local college and admits to having a very busy schedule and difficulty managing stress. She is concerned about her ability to be adherent to an extended duration treatment regimen. The physician asks you for your recommendation on an appropriate regimen to treat CK’s latent TB. CK has no other medical conditions and is not currently taking any prescription medications. 

Which latent TB treatment regimen would you recommend for CK?

 


References:

1. Kirkwood CK, Melton ST. Insomnia, drowsiness, and fatigue. In: Krinsky DL, Berardi RR, Ferreri SP, et al, eds. Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care. 17th ed. Washington, DC: American Pharmacists Association; 2012:867-883.

2. Morin AK, Jarvis CI, Lynch AM. Therapeutic options for sleep maintenance and sleep-onset insomnia. Pharmacotherapy. 2007;27:89-110.

3. Shimp LA. Disorders related to menstruation. In: Krinsky DL, Berardi RR, Ferreri SP, et al, eds. Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care. 17th ed. Washington, DC: American Pharmacists Association; 2012:147-158.

4. St. John’s wort and depression. National Institutes of Health/National Center for Complementary and Alternative Medicine website. http://nccam.nih.gov/health/stjohnswort/sjw-and-depression.htm. Accessed February 12, 2012.

5. Yanni EA. Jet lag. Centers for Disease Control and Prevention website. http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/jet-lag.htm. New York, NY: Oxford University Press; 2012.

6. Herxheimer A, Petrie KJ. Melatonin for the prevention and treatment of jet lag. Cochrane Database Syst Rev. 2002;(2):CD001520.

7. Dennehy CE, Tsourounis C. Botanicals (“herbal medications”) and nutritional supplements. In: Katzung BG, ed. Basic and Clinical Pharmacology. 10th ed. New York, NY: Lange/McGraw Hill; 2007:1060-1062.

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