Case Studies

OCTOBER 01, 2008
Craig I. Coleman, PharmD

Dr. Coleman is an assistant professor of pharmacy practice and director of the pharmacoeconomics and outcomes studies group at the University of Connecticut School of Pharmacy.

Heliobacter pylori Eradication

HP is a 42-year-old man who comes to the pharmacy counter at a major grocery store pharmacy with prescriptions for clarithromycin 500 g twice daily, metronidazole 500 mg twice daily, and lansoprazole 30 mg twice daily for 14 days. HP had just come from his physician's office across the street, where he was told that he was infected with a bacterium called Helicobacter pylori. The pharmacist fills the prescription and starts to counsel HP on the importance of completing the entire course of antibiotic therapy when she notices a 6-pack of beer in HP's shopping cart.

What should the pharmacist do next? What would an alternative regimen contain?

Nasal Congestion

RM is a 33-year-old man who comes to the pharmacy counter with 2 boxes of phenylephrine nasal drops. The pharmacy technician asks the patient if there is anything else she can help him with today, and in a very congested voice, RM asks if he could speak with a pharmacist. When the pharmacist comes over to the counter, RM asks "are there any stronger nasal decongestants than these?" Upon questioning by the pharmacist, RM admits to using the phenylephrine nasal drops for the past week or so, noting "initially they worked great, but now not so much."

How should the pharmacist respond to RM's question?