In this hyperkalemia case study, I outline the importance of paying attention when medications are discontinued. EN is a 78-year-old female with chronic kidney disease stage 4, hypertension, heart failure with preserved ejection fraction, and type 2 diabetes. She had...
KE is a 72-year-old female residing in a long-term care facility. She was recently started on ciprofloxacin 500 mg PO BID for a complicated urinary tract infection caused by E. coli. Over the past week, nursing staff noticed she continued to spike fevers, complain of...
I think I’ve seen this scenario play out more times than I would like. A patient is prescribed both a laxative, Senna, and Questran (cholestyramine), a medication used to manage diarrhea symptoms. This example of the prescribing cascade often presents slowly...
One of my biggest pet peeves is the use of sulfonylureas with insulin. Recall that sulfonylureas stimulate the release of insulin and in many patients with Type 2 diabetes we may not be getting much out of the sulfonylurea or in some cases, the extra boost in insulin...
Nitrofurantoin is often used in patients for UTI prophylaxis. One potential concern with nitrofurantoin use is pulmonary toxicity. This can often be overlooked in patients as a potential cause of respiratory problems. Here’s a case scenario where nitrofurantoin...
JK is a 77-year-old male who reports a 1-week history of intermittent dizziness and episodes of loss of balance, particularly when walking around. He denies any recent falls, headaches, visual changes, or chest pain. He describes the sensation as...
