Clinical Case Studies in Pharmacy

Patient Case Study 1

• A 65-year-old woman presented to the clinic with constipation for two weeks.
• Her stool was hard and bullet-like.
• She had no significant medical history, did not smoke, but drank alcohol socially.
• Blood pressure was 110/70 mmHg, pulse 70/min, and temperature 37.5°C.
• She had used over-the-counter medication for constipation.
• Docusate sodium is a stool softener.

Drug Classification

• Docusate sodium is a demulcent (stool softener).

Patient Case Study 2

• A patient with right maxillary sinus pain, nasal congestion, and thick yellow nasal secretions.
• Used nasal decongestant spray, saline spray and anti-inflammatories for several days.
• Presented with persistent thick drainage, worsening pain, low-grade fever and pain around the right second maxillary molar on day 10.
• Amoxicillin + clavulanate is the first-line antibiotic for sinusitis.

Patient Case Study 3

• A 72-year-old female patient with lower-risk myelodysplastic neoplasms (LR-MDS).
• Characterized by symptomatic anemia that is transfusion-dependent.
• Erythropoietin (EPO) level was 200 mU/mL.
• Cytogenetic analysis revealed a deletion on the long arm of chromosome 5 [5q (del(5q))] abnormality.
• Platelets and neutrophil counts were normal.
• Lenalidomide is a preferred treatment option for EPO level.

Patient Case Study 4

• A 34-year-old woman for contraceptive options, had a baby one month prior via a vaginal delivery.
• Used condoms.
• Medical history significant for pulmonary embolism and DVT four years ago, chronic liver disease, migraine, coronary artery disease, and PCOS.
• Smoker.
• A history of venous thromboembolism is an absolute contraindication for OCPs.

Patient Case Study 5

• A 65-year-old man presented with fatigue and weight loss.
• Fecal occult blood test was positive.
• Colonoscopy revealed a mass in the sigmoid colon.
• PET scan showed metastases to the liver.
• Monoclonal antibody targeted against vascular endothelial growth factor (VEGF-A) as a treatment option.

Patient Case Study 6

• A 27-year-old man with shortness of breath.
• No chest pain; no loss of consciousness or palpitations.
• Smoked; consumed 2-3 beers per weekend.
• Mother with breast cancer; paternal uncle died young.
• Systolic ejection murmur.
• Left ventricular ejection fraction was 76%.
• Metoprolol (cardioselective beta-blocker) is appropriate next step.

Patient Case Study 7

• An 80-year-old woman unresponsive.
• Blood glucose 46 mg/dL (2.55 mmol/l) at the scene.
• History of type 2 diabetes and insulin pump use.
• Received a dose of D50 (50% dextrose) in the ambulance.
• Responsiveness returned.
• Change injection sites or needle locations every 48-72 hours unless infected or malfunctioning.

Patient Case Study 8

• A 23-year-old woman with a left eye infection.
• Blood pressure 122/80 mmHg, pulse 90/min, respiratory rate 14/min, and temperature 99.5°F (37.5°C).
• History of cystic fibrosis, type 2 diabetes mellitus, and IgA nephropathy.
• Tobramycin ophthalmic solution is considered for eye infection.
• Renal function needs to be closely monitored before prescribing Tobramycin.

Patient Case Study 9

• A patient experiencing drug toxicity after 3 days of gentamicin therapy, likely exhibiting elevated creatinine or protein in urine.

Patient Case Study 10

• A 84-year-old man with acute-onset community-acquired pneumonia.
• Positive sputum culture for S. pneumoniae.
• History of atrial fibrillation controlled by Class III antiarrhythmic sotalol.
• Doxycycline is the preferred treatment for pneumonia.

Patient Case Study 11

• A 55-year-old man with oral white plaques and dysphagia.
• HIV testing is positive.
• Initial improvement with antifungal and lamivudine monotherapy but six months later shows an increase in HIV-1 RNA levels to 10000 copies/mL.
• Resistance to lamivudine is the most likely cause.

Patient Case Study 12

• A 65-year-old woman with a history of osteoporosis.
• Not responding treatment adequately to bisphosphonate
• Abaloparatide may have an increased risk of osteosarcoma (black box warning) for treatment.

This quiz explores various patient case studies focusing on common medical conditions and their treatments. From constipation management using docusate sodium to sinusitis treatment with amoxicillin and clavulanate, examine the implications of drug classifications in real-world scenarios. Test your knowledge on effective patient care strategies and medication use.