Posted: September 13th, 2017

Case study;Therapeutics Endocrine and Metabolism Endocrine Case Studies

Case study;Therapeutics Endocrine and Metabolism Endocrine Case Studies

Therapeutics Endocrine and Metabolism Endocrine Case Studies
1- Below is 1 case study relating to Pharmacy Practice and Therapeutics  Endocrine Case Study.

3- Please answer the questions carefully accompanying each clinical scenario, and reference the answers well.
4- You are required to answer the specific questions associated with the following cases.
5- Please consider each aspect and address the issues in terms of providing the best available pharmaceutical care.
6- Support your responses through appropriate research, using various sources (i.e. not just text books, but also journal articles).
7- You are to pay particular attention to proper referencing, both in text, as well as at the end of your assignment.

Assessment criteria:
1-    Presentation (2) Is the case study presented in accordance with the required guidelines for presentation of assignments. Note! There is a new FSTE First Year Survival Guide from Bookshop. e.g. Double Spaced, Page Numbers,40 mm Margins, correct case study on the title page, student authorship form.

2-    Correct Information (4) Are the answers to the questions scientifically and clinically correct? Have the correct names been used for medications used in Australia?

3-    Interdisciplinary Answers (3) Do the answers demonstrate an interdisciplinary approach in terms of the medicinal chemistry, pharmacology and pharmacy practice? Are the answers presented clearly to advise a patient or other health care professional?

4-    Precision in Expression (4) Is the expression appropriate for an assignment of this level? Is there appropriate use of language and jargon as necessary? Is it understandable to the lay/expert reader?

5-    Relevance of the Information (4) Was the information in the answers relevant to the specific topic?

6-    Referencing (3) Is the information duly, appropriately and properly referenced? Was the Harvard or APA System used? Was this consistent? Did the selection of references illustrate depth and breadth of reading?

You must be:
• Demonstrate knowledge about structure activity relationships for a selection of drugs used to treat disorders of the endocrine system.
• Explain the pathophysiology associated with diabetes.
• Demonstrate appropriate pharmacy practice skills and judgement when treating a patient diagnosed with a diabetic disease.
• Integrate knowledge from each discipline (medicinal chemistry, pharmacology and pharmacy practice) when answering your case study questions as appropriate.
• Demonstrate knowledge regarding how a patient’s response to drugs or ability to comply with a medication regimen may be altered depending on their age.
• Demonstrate knowledge regarding differences in human metabolism due to ethnicity, age and ultimately genetic profile.
• Create an integrated written report based on a specific case study to address the medication management of a patient with a disease of the digestive system, endocrine system or body metabolism.

Case study
Mrs HP, a 67 yr old female patient comes into your pharmacy with a prescription for Empagliflozin 25mg once a day to improve her blood glucose levels.

Current medication:
Metformin  1000mg twice a day
Glimepiride  1mg daily
Frusemide  40mg in the morning and at midday Potassium Chloride 600mg daily
Candersartan  4mg daily
Escitalopram  5mg daily
Digoxin  62.5mcg daily
Alendronate  70mg weekly
She has been on these medications for the past 6 months but her local GP wants to improve her blood glucose levels with the new medication as prescribed.
Past medical Hx;
Type 2 diabetes (diagnosed 7 years ago), Hypertension, Heart failure

Biochemistry and haematology results from 3 months ago:
Sodium        139 mmol/L (133-145)
Potassium     3.8 mmol/L (3.5-5.2)
eGFR            60 mL/min/1.73 m2
Creatinine     120 µmol/L (60 – 110)
Urea         9.1 mmol/L (2.5 – 8)
Bicarbonate      28 mmol/L  (22 – 30)
Weight: 95kg,
Height: 170cm
Questions:
1.    Describe fully how empagliflozin works in the management of diabetes. Include in your answer specific rationale or clinical benefits in the choice of this therapy for this patient?

2.    Your pharmacy does not stock this medication so you contact the doctor. The doctor still wants to use a drug from this class of medicines. What would be your alternative choice and discuss why you would recommend this particular drug for this patient over another in this class?

3.    Discuss any particular issues with the use of your chosen therapy in this patient? Include in your answer any monitoring that should be considered for the use of this medicine?

4.    Discuss the potential use of liraglutide 0.6mg SC injection once daily for this patient as an alternative therapy for her diabetes management. How does liraglutide work and what are some of the benefits and potential complications of using this medication in this patient?