Advanced Pharmacotherapeutics: Prescribers Case Studies

Woo Page 1 of 1 Pharmacotherapeutics 5e Ch25 Student CS Chapter 25: Drugs Used to Treat Inflammatory Processes

Student Case Study

A 16-year-old female presents with complaint of severe menstrual cramps. She has not tried any

medication for pain. She has no allergies and is not taking any routine medications.

1. What would be an appropriate pain medication for dysmenorrhea?

2. What education should be included in prescribing?

Woo Page 1 of 1 Pharmacotherapeutics 5e Ch44 Student CS Chapter 44: Pain Management: Acute and Chronic Pain

Student Case Study

A 78-year-old male patient comes to your office complaining of increased left knee pain for the

past 3 to 4 months. He has had no history of recent injury. An x-ray done less than 4 months ago

showed degenerative osteoarthritic changes. He has full range of motion and denies any recent

swelling, pedal edema, or discoloration. He has been a long-distance runner for many years and

was diagnosed with osteoarthritis of his left knee more than 10 years ago. He has decreased his

weekly running, but the pain is persistent and is affecting his daily activities. He has been using

over-the-counter NSAIDs on and off, but states they are no longer working and wants something

“stronger.” His vital signs are all normal and he has no history of fever, chills, or rashes. He is

otherwise healthy.

1. How would you approach the management of chronic pain in this patient?

2. What education would you provide when prescribing pain medication for this patient?

Woo Page 1 of 1 Pharmacotherapeutics 5e Ch21 Student CS Chapter 21: Drugs Affecting the Bones and Joints

Student Case Study

A menopausal patient has completed her dual energy x-ray absorptiometry (DEXA) scan, which

shows early osteopenia. She knows her mother had the same issue and was started on

bisphosphonates right away to prevent further decline. She requests similar care. She can’t drink

milk because she is lactose intolerant. She considers herself a couch potato and has a sedentary

job at work. She takes proton pump inhibitor (PPI) meds for her incessant heart burn due to her

moderate obesity and has been on thyroid supplements since high school. She was on Depo-

Provera for less than 2 years during her early college days. She has had two tripping-related

nondisplaced fractures of her wrists in the past 2 years that have healed well. She does have the

need for some major dental work this year.

1. What other pharmaceutical interventions have possibility contributed to her diagnosis?

2. Are there any assessments or interventions concerning these medications that might result in

an improved bone health picture?

3. What about her request to start bisphosphonates now that she is becoming osteopenic?

4. What about her calcium intake and lactose intolerance?

Woo Page 1 of 1 Pharmacotherapeutics 5e Ch18 Student CS Chapter 18: Drugs Affecting the Endocrine System: Pancreatic Hormones and Antidiabetic

Drugs

Student Case Study

You have been following your patient for the past 2 years. You have worked with them to lose

weight by changing lifestyle and nutritional habits. They continue to be overweight (body mass

index [BMI] of 33) and have tried to cut down carbohydrate and fat intake, but now presents

with polyuria, polydipsia, and an elevated random blood sugar of 164. You have ordered an

HbA1c test in the past, and the values were less than 6.2%. However, the most recent test

indicated an HbA1c greater than 7%. They are not on any medications, but does have a sulfa

allergy.

1. Do you have enough evidence to give them a specific diagnosis today?

2. Would you start your treatment with diet and exercise?

3. What is the first medication you would prescribe? Discuss how you determined which one to

give first and how you based this decision on specific factors.

4. What education regarding medication management would you need to do?

5. What other labs are needed before considering other medications to take for his diagnosis?

Woo Page 1 of 1 Pharmacotherapeutics 5e Ch19 Student CS Chapter 19: Drugs Affecting the Endocrine System: Pituitary, Thyroid, and Adrenal Drugs

Student Case Study

Parents have been very concerned about the slow growth of their son. He persistently is at the

lowest percentiles of height in his class. They believe this is starting to impact his self-identify

and confidence. They have read that taller people do better in the US business world. They

believe that height is linked with more promotions and selection for leadership positions. They

are asking if he would be a good candidate for growth hormones. The mother is 5 foot 4 inches,

and the father is 5 foot 6 inches. They were never on the lower scale for height at school in

Mexico City. The child has gained less then 2cm of height in the past year.

1. Using the average expected growth scale, what is the estimated height that this child would

be expected to reach based on parental size?

2. What other information must be gathered from the parents?

3. What might be a consideration about the genetics of this child that can make the

determination of height unreliable using the calculations above?

4. The fact remains that this particular child is not progressing as expected. Is he a candidate

for consultation with an endocrinologist?

Woo Page 1 of 1 Pharmacotherapeutics 5e Ch36 Student CS Chapter 36: Gastroesophageal Reflux and Peptic Ulcer Disease

Student Case Study

A 46-year-old male presents with a complaint of “heartburn” for the past 3 months. He describes

the pain as burning and located in the epigastric area. The pain improves after he takes an antacid

or drinks milk. He has been taking either over-the-counter famotidine or ranitidine off and on for

the past 2 months and he still has recurring epigastric pain. He has lost 6 pounds since his last

visit. He is a nonsmoker.

His examination is unremarkable. His blood pressure is 118/72 mm Hg. Laboratory

values are normal (including complete blood count [CBC]) and his serum Helicobacter pylori

test is positive.

1. What is the plan of care for Mike?

2. What education does he need?

Woo, Pharmacotherapeutics for APN Prescribers, 4e Student Case Study Answers-24-1

Chapter 24 Drugs Used in Treating Infectious Disease

Answers to Student Case Study

Nick is a 16 year old who presents to the clinic with a sore throat, enlarged cervical lymph nodes,

and a fever of 102°F. His rapid strep test is positive.

1. What is the plan of care for Nick’s strep throat?

Penicillin 500 mg PO bid × 10 days OR

Amoxicillin 1,000 mg PO daily × 10 days

2. What education do Nick and his parents need?

Nick is contagious for 24 hours after antibiotics are started.

He should take the full medication for 10 days to clear infection and prevent rheumatic fever.

Report any symptoms of rash or hypersensitivity. Advanced Pharmacotherapeutics: Prescribers Case Studies