Pharm case studies

Question 1

A 25-year-old woman wants to use herbal remedies during pregnancy.

Answer 1

• Herbal remedies lack proven safety ratings for pregnant women.
• Emphasize the importance of consulting healthcare providers before using herbal products during pregnancy due to potential risks.

Question 2

A 38-year-old man overdoses on acetaminophen

Answer 2

• Hepatic necrosis is the most serious toxic effect of acetaminophen overdose.
• Acute overdose can cause severe liver damage, leading to liver failure if not promptly treated.
• N-Acetylcysteine (NAC) is the antidote for acetaminophen overdose and works by replenishing glutathione.

Question 3

A 51-year-old woman on SERMs for postmenopausal osteoporosis

Answer 3

• Venous thromboembolism is a contraindication for SERMs.
• SERMs can increase the risk of blood clots, which is critical in patients with a history of thromboembolic events.
• Raloxifene (Evista): used for osteoporosis, but careful monitoring is needed for thromboembolic risks.

Question 4

A 6-year-old with chickenpox and fever.

Answer 4

• Aspirin is contraindicated in children with viral infections due to the risk of Reye’s syndrome.
• Acetaminophen or ibuprofen are safer alternatives for reducing fever in children
• Acetaminophen (Tylenol): preferred for fever management in pediatric patients.

Question 5

A 75-year-old woman with muscle twitching after excessive sodium bicarbonate intake.

Answer 5

• Metabolic alkalosis can occur with overuse of sodium bicarbonate.
• Symptoms include muscle twitching, nausea, and headache due to alkalotic state.
• Sodium Bicarbonate: overuse can lead to alkalosis, requiring careful monitoring of acid-base balance.

Question 6

A 79-year-old patient on a quinolone for infection.

Answer 6

• Tendonitis and tendon rupture are associated adverse effects with quinolones, particularly in older adults.
• Close monitoring is necessary to prevent tendon damage.
• Ciprofloxacin (Cipro): a commonly used quinolone with potential for severe musculoskeletal side effects.

Question 7

A 79-year-old on a diuretic for hypertension.

Answer 7

• Orthostatic hypotension is a risk with diuretics, necessitating precautions when standing.
• Educate on the importance of rising slowly to prevent falls.
  *Hydrochlorothiazide (HCTZ): commonly prescribed diuretic requiring patient education on side effects.

Question 8

A toddler potentially ingests an entire bottle of aspirin.

Answer 8

• Hyperventilation and drowsiness are common signs of salicylate intoxication in children.
• Immediate medical evaluation is crucial.
• Activated Charcoal: used in acute overdose to reduce absorption if presented early.

Question 9

A patient asks about monoclonal antibodies for cancer treatment

Answer 9

• Monoclonal antibodies target specific tumor cells while sparing normal cells, reducing side effects.
• Rituximab (Rituxan): a monoclonal antibody used in various cancers, demonstrating targeted therapy advantages.

Question 10

A patient asks about the difference between Lomotil and Imodium.

Answer 10

• Imodium (loperamide) does not cause physical dependence, unlike Lomotil (diphenoxylate/atropie)
• Loperamide (Imodium): preferred for its safety profile in long-term use.

Question 11

A patient wants to take ginkgo for memory.

Answer 11

• Ginkgo biloba can increase bleeding risk, especially when taken with anticoagulants like aspirin.
• Ginkgo Biloba: herbal supplement requiring caution with concurrent anticoagulant or antiplatelet therapy.

Question 12

A patient without cancer is prescribed adalimumab.

Answer 12

• Adalimumab is used to treat rheumatoid arthritis among other autoimmune conditions.
• Adalimumab (Humira): targets TNF-alpha to reduce inflammation in autoimmune diseases.