pharmacology case study
Case Study
Your patient is a 75 year old male admitted through the Emergency Room w/ cough, SOB and fever, Chest x-ray revealed left lower lobe pneumonia.
Past Medical History: Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), hypertension, Diabetes Mellitus –Type 2, Gout, chronic renal insufficiency.
Allergies: PCN
Current medications: Avandia (rosiglitazone) 2mg BID Glucophage (metformin) 500mg OD Lasix (furosemide) 40 mg daily Potassium supplements (KCl) 20 meq daily Lopressor (metoprolol) 25 mg BID Prinivil (lisinopril) 5 mg daily Allopurinol (zyloprim) 100mg daily Advair 1 inhalation BID He is started on IV Zithromax (azithromycin) and Albuterol via nebulizer treatment.
Questions:
· Identify the drug classification and briefly describe the mechanism of action for each of the drugs listed above.
· What laboratory parameters would be routinely monitored in the above patient
- Lasix: BUN, creatinine & electrolytes (specifically potassium) loop diuretic therapy
- Avandia: monitor LFT’s (increase sensitivity at of insulin at the receptor site)
- Metformin: use cautiously with renal insufficiency patients—monitor BUN and creatinine (if levels are too high, not a candidate for biguinides)
- Potassium supplements: potassium levels
- Metaprolol: monitor blood glucose can mask signs of hypoglycemia
- Prinivil: monitor potassium levels (has a tendency to increase),
- Allopurinol: monitor BUN, creatinine
· Why was Zithromax chosen to treat this patient?
- Zithromax was chosen to treat this patient because it doesn’t interact with liver function and it has a broader range of coverage for both gram (+) and gram (-) bacteria that can treat the pneumonia that is possibly causing the fever. This patient is also allergic to penicillin.
· What factor increases this patient’s risk for gout?
Your patient is a 75 year old male admitted through the Emergency Room w/ cough, SOB and fever, Chest x-ray revealed left lower lobe pneumonia.
Past Medical History: Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), hypertension, Diabetes Mellitus –Type 2, Gout, chronic renal insufficiency.
Allergies: PCN
Current medications: Avandia (rosiglitazone) 2mg BID Glucophage (metformin) 500mg OD Lasix (furosemide) 40 mg daily Potassium supplements (KCl) 20 meq daily Lopressor (metoprolol) 25 mg BID Prinivil (lisinopril) 5 mg daily Allopurinol (zyloprim) 100mg daily Advair 1 inhalation BID He is started on IV Zithromax (azithromycin) and Albuterol via nebulizer treatment.
Questions:
· Identify the drug classification and briefly describe the mechanism of action for each of the drugs listed above.
· What laboratory parameters would be routinely monitored in the above patient
- Lasix: BUN, creatinine & electrolytes (specifically potassium) loop diuretic therapy
- Avandia: monitor LFT’s (increase sensitivity at of insulin at the receptor site)
- Metformin: use cautiously with renal insufficiency patients—monitor BUN and creatinine (if levels are too high, not a candidate for biguinides)
- Potassium supplements: potassium levels
- Metaprolol: monitor blood glucose can mask signs of hypoglycemia
- Prinivil: monitor potassium levels (has a tendency to increase),
- Allopurinol: monitor BUN, creatinine
· Why was Zithromax chosen to treat this patient?
- Zithromax was chosen to treat this patient because it doesn’t interact with liver function and it has a broader range of coverage for both gram (+) and gram (-) bacteria that can treat the pneumonia that is possibly causing the fever. This patient is also allergic to penicillin.
· What factor increases this patient’s risk for gout?