Case Studies

MAY 17, 2013
Diana M. Sobieraj, PharmD, and Craig I. Coleman, PharmD
Case 1
SD is a 59-year-old man with stable coronary artery disease and exertional angina that is being medically managed. He also suffers from chronic obstructive pulmonary disease (COPD), hyperlipidemia, and is a current smoker. SD has received a trial of metoprolol succinate, requiring the maximal dose for angina relief. Unfortunately, SD was unable to tolerate the exacerbation of his COPD symptoms that resulted. SD has also tried nitrates, but had to discontinue therapy because he suffered intolerable headaches.
What other therapies are available for the treatment of SD’s angina?

Case 2
MJ is a 63-year-old woman with type 2 diabetes, hypertension, and mild heart failure. Her glycemic control is consistently suboptimal (A1C = 7.9%) despite taking metformin 1000 mg twice daily and glyburide 10 mg daily for a few months. Today, MJ comes to pick up her refills and begins to discuss her diabetes control with you. She reports taking her medications daily and that gaining better control of her diabetes is a priority to her, but states, “I am not ready to start injecting myself and prefer to stick to pills.” Her provider would like to initiate a third agent.
What options are available to MJ?
Dr. Sobieraj is assistant professor of pharmacy practice 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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