Question

Patient CJ (case provided below) brings a new prescription for metformin 500 mg BID. She also asks for a recommendation for a good over the counter product that can be used to treat her seasonal allergies.

CJ is a 53 year old African American female presenting to pharmacy for first-time certification and CMR so that she may start getting her medications at no cost. CJ states that her main concern about her health is her diabetes.

PMH: T2DM, HTN, hyperlipidemia

SH: denies tobacco and illicit drug use, occasional alcohol use (1-2 drinks/month)

FH: unknown

Allergies: penicillin (unknown reaction; had reaction when young).

Medications: lisinopril 5 mg daily aspirin 81 mg daily simvastatin 20 mg daily Wt 231 lbs (105 kg), Ht 5’6”, BMI 37.3 (obese), IBW 59.3 kg, BP 145/80, HR 98, random blood glucose 395, A1C 11.2%, estimated 10-year ASCVD risk 9.5%

Drug-related problems:

1. Uncontrolled T2DM

2. Uncontrolled HTN

3. Suboptimal statin intensity

1/ Identify two pieces of objective data included in this case:

2/What kind of monitoring needs performed for the new prescription for this patient?

3/Based on your case how would you counsel the patient on the new prescription medication? Provide examples of specific aspects you would include in your patient education.

4/Review your patient case. Identify any medications that do not have a corresponding disease state.

5/Review your patient case. Identify any disease states are not treated by current medications.

6/What OTC (over the counter) product would you recommend for this patient (based on the patient request for an OTC product? Include dose, frequency of administration, route of administration, and critical counseling points.

7/How would you apply the principles of the Pharmacists' Patient Care Process to this patient interaction? You can review this process at: https://www.pharmacist.com/sites/default/files/files/PatientCareProcess.pdf

Answer 1

1, The two pieces of objective data that can be gathered from the above case is that the patient is Diabetic having family history of diabetes, hypertention and hyperlipidemia. The patient is having seasonal allergies.

2. The patient blood sugar needs to me monitored for a certain time period. HbA1c may be measured. The blood pressure level, the cholesterol lavel need to be tested.

3. I will counsel the patient about the importance of the medication and how it can help her to control her blood sugar. I will also educate her about the complication and risk of high blood pressure. Will tell her to modify her diet habits and lifestyle if any requirement is there. She also need to be educated how the prescription medicine work.

4. Aspirin is the medication that do not have corresponding disease.

5.The condition seasonal allergy is not treated with the current medication

6. The OTC product I will recommend is Cetirizine (Zyrtec)

7. I would apply the the principles of Pharmacists Patient care Process like follows:

As the information is provided I will if any additional information is required. I will assess all the data provided inluding her current diseases, past medical history, treatment received, Laboratory data. Then I will plan her treatment. Including the medication, patient education, any further investigation required. Then need to implement the treatment plan. After the implementation it is important to monitor and follow-up and review the treatment if required.