Question

Case study:

JD is a 58-year-old male patient who is suffering from latent TB. The treating physician is choosing a prophylactic regimen for JD and evaluating treatment with rifampin for a 4 months course. Please evaluate if rifampin is a good drug choice for JD and what potential complications this treatment option will pose for JD.

JD’s current medication list includes:

▪Warfarin 5 mg daily

▪Oxcarbazepine 2 g daily

▪Metoprolol succinate 50 mg daily

▪Lisinopril 20 mg daily

▪Simvastatin 20 mg daily

Questions based on the case study:

1) List each drug-drug interaction with existing regimen and pharmacology of interaction

2. List the medical risks due to each drug interaction

3. List any potential dose adjustments I.e. dose should be increased/decreased

4. List any required monitoring I.e. lab values, drug levels, side effects, etc.

you just need to answer the question below given the information in the case study.

Answer 1

1,Rifampin has reported to increase the warfarin requirementa in human subject s ingesting these agents simultaniously

concominant administration of rifampicin and oxcarbazepine results in a significant decrease of the active MHD metaboliteof oxcarbazepin.

Rifampicin is a potent inducer of cytochrome enzyme and decrease serum levels of commonly used antihypertensive drugs

the combination of lisinopril and rifampicin causes high risk dangerous interactions

the Rifampin greatly decreases the plasma concentration of simvastain and simvastatin

2, Using rifampin with warfarin there will be the chance of low density of andticoagulant

when we are using oxcarbazepine sgnificalnt decrese of active MHD

if rifampin used with antihypertensive drugs there will be the chances of high blood pressure

last drug rifampiciin decreases the concetration in blood and deserved effect wont get

3, If doctor desided to use the drug Rifampin it have serious drug interaction with other drugs ,if he contine means shoud increase the dose of warfarin,anti hyper tensive and simvastatin and should decrease the dose of lisinopril or use some substitutes.

4, The serum druug values should access periodically to avoid overdosage

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