Case Studies

Craig I. Coleman, PharmD, and Brendan Limone, PharmD
Published Online: Friday, February 15, 2013
Follow Pharmacy_Times:
Case 1
EW is a 58-year-old woman with a past history of hypertension and type 2 diabetes who presents to the emergency department complaining of nausea, shortness of breath, and chest discomfort radiating down her left arm. EW is determined to be suffering an acute coronary syndrome (ACS) and is treated with primary percutaneous coronary intervention (PCI). After PCI, her interventional cardiologist starts her on aspirin 325 mg/day and clopidogrel 75 mg/day. Two days later, the pharmacist recommends EW undergo “on-P2Y12 (clopidogrel)” platelet reactivity testing. The test comes back with a platelet reaction unit (PRU) value of 245. EW is not taking any medications that could potentially interact with her antiplatelet therapy.
What is the significance of this result and how might the pharmacist use it to optimize EW’s care?

Case 2
AQ is an otherwise healthy 23-year-old woman who comes to the outpatient clinic complaining of painful urination and flank pain for the past 2 days. During her visit, AQ’s temperature is found to be elevated at 101.6° F. A urine dipstick test is performed and comes back positive for pyuria (white blood cells in the urine) and leukocyte esterase. AQ is diagnosed with having an uncomplicated pyelonephritis. Her treating physician determines she does not need to be admitted, but orders her urine be cultured and bacterial susceptibility tests be performed.
What is the recommended treatment course for AQ?

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. Dr. Limone is a pharmacy fellow in the HOPE Collaborative Group at the University of Connecticut School of Pharmacy and Hartford Hospital.

Related Articles
A veritable alphabet soup of hypertension guidelines have been released over the past year. Here is what you need to know.
The FDA refused to approve the ultra-long-acting insulin treatments 2 years ago.
Glyxambi is now available by prescription at pharmacies across the United States.
A pharmacy school team nabbed second place in the Mississippi Public Universities’ Blueprint Mississippi Social Business Challenge.
Latest Issues
  • photo
    Pharmacy Times
    Health-System Edition
    Directions in Pharmacy
    OTC Guide
    Generic Supplements
  • photo
    Pharmacy Careers
    Specialty Pharmacy Times