Case Studies

MARCH 01, 2009
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.

Thyroid Replacement

TT is a 66-year-old woman with newly diagnosed hypothyroidism who comes to the pharmacy with her first prescription for levothyroxine 75 mcg daily and hands it to the pharmacist. The pharmacist pulls up TT?s medication profile and notes that she is taking aspirin 81 mg daily, clopidogrel 75 mg daily, atorvastatin 80 mg daily, and amlodipine 10 mg daily. When asked by the pharmacist, TT admits to having undergone coronary revascularization about 2 months ago after a bout of chest pain.

What concerns should the pharmacist have regarding TT?s new levothyroxine prescription?

Community-Acquired Pneumonia

SP is a 42-year-old man who goes to the emergency department (ED) complaining of a fever and shortness of breath. SP has a medical history significant for type 2 diabetes and hypertension. He is currently taking metformin, glipizide, and lisinopril. SP has a documented allergy to cephalosporins (described as facial swelling) in his chart. While in the ED, SP is diagnosed with community-acquired pneumonia (CAP) and his doctor decides that he can be treated on an outpatient basis. As part of his discharge instructions, SP is given a prescription for levofloxacin 750 mg daily for 7 days.

Is SP being treated appropriately for CAP?