Case Studies - June 2012

Case 1

JT is a 55-year-old man with a past medical history of chronic kidney disease, type 2 diabetes mellitus, and hypertension. He is admitted to the hospital for community-acquired pneumonia, and during his stay he is also diagnosed with new-onset nonrheumatic atrial fibrillation (AF). The resident who presents JT on rounds knows that recent changes were made to the American College of Chest Physicians guidelines for stroke prevention in AF, but he does not remember the specifics. He asks the clinical pharmacist whether dabigatran would be appropriate for stroke prevention in this patient.

How should the pharmacist respond?

Case 2

CP is a 61-year-old otherwise healthy man scheduled to undergo a total hip replacement. The surgical team decides to start enoxaparin, a low-molecular-weight heparin, after his surgery for venous thromboembolism (VTE) prophylaxis. During rounds on the surgical floor, the clinical pharmacist reviewed the patient’s medical chart and decides to visit the patient to address any questions. The patient mentions that he is ready for surgery but is concerned about having to be on a blood thinner for a long time after his surgery.

How should the pharmacist respond? Submit your answers in the spaces to the right, and you'll be entered into a contest to win an iPad!