A 48 year old female has a history of diabetic neuropathy and has been placed on Cymbalta (duloxetine). The patient has taken it for three days and is feeling pretty fatigued throughout the day from it. She asks, “How long does it take Cymbalta to work for...
Acetylcholinesterase Inhibitors are used in various forms of dementia. They can provide some symptom improvement in dementia, but cannot reverse or stop its progression. We need to remember that the agents aren’t without risk. Here’s a case to remember...
In this case scenario, I’m going to demonstrate and unusual side effect of galactorrhea. Reglan induced galactorrhea is a possibility due to the mechanism of dopamine blockade. The case: A 46 year old female obese female has a history of type 2 diabetes. She...
Working in geriatrics, you run into a lot of tough questions where there isn’t always a perfect answer. Setting a goal A1C is sometimes one of those challenges. Here’s a scenario where a patient has an A1C of 8.2. Under most conditions, an A1C of 8.2 is...
SK is an 80 year old male with a history of BPH, hypertension, CAD, diabetes, and atrial fibrillation. His current medications include: Warfarin – goal INR 2-3 Aspirin 81 mg daily Lisinopril 10 mg once daily Tamsulosin 0.8 mg once daily Finasteride 5 mg once daily...
You can’t tell everything from a medication list, but you can certainly begin to formulate questions and identify possible areas of concern. What do you notice that seems a little wacky? Here’s a patient with severe asthma, on multiple medications: Advair...
