Case Studies

AUGUST 08, 2013
Brienne L. Dufresne, PharmD Candidate, and Craig I. Coleman, PharmD
Case 1
AC is a 28-year-old man recently diagnosed with HIV infection. With a CD4 count of 300 cells/mm3, AC was started on first-line highly active antiretroviral therapy (HAART) consisting of ritonavir-boosted atazanavir + tenofovir/emtricitabine. A fasting lipid profile taken on initiation of his HAART regimen and 4 weeks after initiation revealed lipid levels within normal range. However, his most recent fasting lipid profile revealed an elevated LDL cholesterol level of 184 mg/dL and a slightly low HDL cholesterol level. AC has been a 1-pack-per-day smoker for the past 10 years but has no other comorbidities. AC’s goal LDL cholesterol is <130 mg/dL due to his multiple risks for coronary heart disease. AC presents to the pharmacy today with a new prescription for simvastatin 20 mg daily.
As the pharmacist, what suggestions (if any) would you make to AC’s prescribing physician?

Case 2
LM is a 63-year-old woman who reports frequent nightly awakenings and trips to the bathroom several nights per week. LM explains that she often gets the urge to urinate unexpectedly and cannot always make it to the bathroom in time. She tells you of an incident last week when she “was out shopping with friends and had an accident in the store.” LM was terribly embarrassed and does not want that to ever happen again. She asks you, as her pharmacist, what she can do to treat her frequent and sometimes uncontrollable urge to go to the bathroom.
What advice should you, the pharmacist, give LM?

Brienne L. Dufresne is a PharmD candidate and 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.

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