Case Studies (March 2018)

MARCH 23, 2018
Rafay Ali, PharmD Candidate; Christine G. Kohn, PharmD; and Craig I. Coleman, PharmD
A father comes in to your pharmacy with a prescription for 250 mg of levofloxacin twice daily for 10 days for his 13-year-old son AV who has been complaining of facial pressure, nasal congestion, and rhinorrhea for the past 10 days. After outpatient observation without improvement, AV’s pediatrician diagnosed him with bacterial sinusitis. Taking a look at AV’s profile, you note that he has a non-type 1 allergy to penicillin. According to his chart, AV weighs 110 lb (50 kg), takes no other medications, and has no known drug allergies.

As the pharmacist, do you believe this is an appropriate drug regimen? If not, what would be your recommendation?

IB, a 38-year-old female and one of your regular patients, comes in to pick up her refill of Tivicay (dolutegravir) and Truvada (emtricitabine/tenofovir). While talking with her, you notice that her tongue seems to be abnormally white. You have IB come to the consultation window so you can examine her mouth, where you see that she has a large plaque-like lesion on her tongue. IB informs you that she noticed the lesion a few days ago, but says that she has not sought treatment because it is not painful. IB was diagnosed with HIV 4 years ago, but has no other conditions, does not take any other medications, and has no known drug allergies.

As the pharmacist, what would you suggest to IB?