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Medication error
I had a case a while back where a patient had an elevated TSH at around 13. The patient was on a dose of 112 mcg 2 tablets daily. If you put yourself in the shoes of the provider, you can imagine...
Cimetidine and Drug Interactions
There was an 85 year old female with an extensive seizure history on Dilantin 300 mg daily. Previous Dilantin level was 14 and the patient was not displaying any signs or symptoms of toxicity. They...
Polypharmacy – What Does it Look Like?
Polypharmacy is a horrible problem in geriatrics. I came across this medication list, and just wanted to give you a brief idea of some of the thoughts that go through a clinical pharmacist's head....
Trazodone use for Insomnia
A 68 year old female was having difficulty with some anxiety throughout the day but more problematic to the patient was that she could not sleep at night. Multiple different non-drug interventions...
Drug Induced Hypertension Case
This 76 year old patient was on a laundry list of blood pressure medications. Hydrochlorothiazide, losartan, metoprolol, terazosin, amlodipine, and recently had clonidine added to their regimen with...
Drug Interaction Causing Pregnancy
A 32 year old female has been struggling with fatigue, sadness, and overall symptoms of depression. Rather than utilizing traditional antidepressants as recommended by her primary care provider, the...
Actos (pioglitazone) and CHF
A patient's A1C was chronically high at around 9.0 with poor diet compliance. They were already reciving a fairly high dose of a sulfonylurea (glipizide) - remember that sulfonylureas stimulate the...
Patient Experience with Insulin Pens
I can remember doing a home visit with a patient who had recently been discharged from the hospital. This particular individual had a recent CHF exacerbation as well as pneumonia. I will never...
Aldactone (spironolactone) case
Often in CHF you may see spironolactone used in combination with loops and other diuretics to try to help treat edema. There are certainly other indications for spironolactone, but I'll leave that...
Gabapentin and Kidney Function Changes
This elderly patient had been on a dose of (Neurontin) gabapentin 600 mg three times daily for peripheral neuropathy. Over time, the patient's kidney function had been declining and was diagnosed...
Study Materials For Pharmacists
