01 Jan Discuss the evidence for any CLINICALLY RELEVANT interactions that may occur between the prescription medicines and the active ingredients in the complementary alternative medicines that the patient has identified in his medication histor
Case Scenario PARA3006: Applied Pharmacology: Integrated Clinical Case Patient Background (Part 1) For much of his life Howard Bloom rarely saw his GP, however in the last 5 years he has needed to visit his GP with increasing frequency to address a numbe r of ongoing medical conditions. The fo llowing baseline characteristics were recorded at his last GP visit, which was one week ago: Age 63years Height 178cm Weight 98kg Blood Pressure 146/87mmHg Occupation Chief Information Officer (CIO) at KPMG Pulse 67bpm Smoking status Non-smoker Alcohol status Social drinker (8-12 std drinks / week) with history of heavy drinking (20-40 std drinks / week) until 5 years ago Blood analysis Fasting blood glucose 14.2mmol/L (healthy 3 ? 5.4mmol/L) HbA1c 7.8 (healthy < 4.8) GFR (measured as creatinine clearance) 78mL/min (healthy > 90mL/min) Child-Pugh score 5 (healthy < 5) Cholesterol 6.4mmol/L (healthy < 5.5mmol/L) Plasma albumin 39g/dL (healthy 32 to 54 g/L) Prescription medication history Probitor (20mg OD), Cardiprin (100mg OD), Zocor (40mg OD), Endone (5mg PRN), Coversyl (5mg OD), Lasix (40mg OD), Noten (50mg OD) and Diaformin (850mg BD). Medical history History of ischaemic heart disease, type-2 diabetes, congestive cardiac failure, gastro-oesophageal reflux, and recent surgery to repair a partial torn ligament in left shoulder (3 weeks ago). 1. For each prescription medications listed in the patients prescription medication history determine the: a. Generic name b. Drug class c. Approved indications d. Regulatory schedule Scenario (Part 2) At 6:15am on a Wednesday morning, Howard has called 000 after experiencing a sudden onset of shortness of breath and chest pain while lying in bed shortly after waking up. You attend the call and perf orm an initial assessment which reveals: Primary complaint Feeling of pressure on chest, uncomfortable (nauseous) feeling in stomach. Level of consciousness Alert and conscious, can recall the time, identity and location. Airway and breathing Airway is clear however patient is visibly short of breath. Circulation Radial pulse is
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