Understanding Drug Therapy Issues: A Case Study in Pharmacy Care

CC, a 72 year old female, complains to the pharmacist that her stomach has been bothering her recently. Current medications include: levothyroxine 0.1 mg po daily (x 30 years), acetaminophen 500 mg po qid (x 5 months), atorvastatin 40 mg po hs (x 4 years), ibuprofen 400 mg po tid prn for joint pain (x 2 months) and zopiclone 3.75 mg po hs prn (x 3 months). Which of the following drug therapy problems is most likely contributing to CC’s recent symptoms?

• A. Too high a dosage of atorvastatin
• B. Too high a dosage of zopiclone
• C. Use of ibuprofen without gastroprotection
• D. Drug interaction between atorvastatin and zopiclone

Answer: (C)

The most likely drug therapy problem contributing to CC's recent symptoms is the use of ibuprofen without gastroprotection. Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) and long-term use can increase the risk of stomach irritation and even ulcers. CC has been taking ibuprofen for joint pain for 2 months and may not be aware of the potential harm it can cause to her stomach. While options A and B may also be possible contributors to her symptoms, there is no information in the question that suggests she is experiencing side effects from these medications. Option D may also be a potential issue, as both atorvastatin and zopiclone can cause drowsiness, but this is less likely to be the main culprit. Regardless, it is important for CC to speak with her doctor or pharmacist about the potential risks of taking ibupro

In the world of pharmacy care, understanding the nuances of drug therapy problems is crucial, isn’t it? Let’s take a closer look at a case involving a 72-year-old woman, CC, who presents with some unsettling stomach issues. After countless years of being on medication, she finds herself perplexed by her recent discomfort. Sounds familiar, right?

CC has a medical history that includes levothyroxine for her thyroid, acetaminophen for pain management, atorvastatin for cholesterol, and recently introduced ibuprofen to tackle joint pain. It’s a lot to manage, especially when it seems like an innocent pain reliever is the culprit of her new symptoms!

So, here’s the question: what could possibly be going wrong with CC's medication regimen? She’s been feeling upset in the stomach, and among her current medications, we need to sift through potential drug therapy problems. Analyzing the options can be a bit like trying to solve a puzzle on a lazy Sunday afternoon, so let’s break it down.

Too High a Dosage of Atorvastatin? That sounds worrisome. However, considering that CC has used atorvastatin for four years without any reported side effects in the scenario, we might steer clear of this one.

Then there’s Zopiclone. The thought of offering extra sleep is always lovely, but the dose she’s on — just 3.75 mg — isn’t really alarming here. No evidence indicates she’s having major side effects, so that path leads us nowhere.

Now, what about the real troublemaker—Ibuprofen without Gastroprotection? Bingo! Ibuprofen's been great for joint pain, but here’s the kicker: long-term use of NSAIDs like ibuprofen can cause serious stomach irritation. It can feel like a betrayal when a simple painkiller turns against you, right? Poor CC has been using it for two months, and she may not even be aware of the risks to her gastric health.

Finally, we can’t completely overlook drug interaction concerns between Atorvastatin and Zopiclone. Sure, both can induce drowsiness, which might sound serious. However, that just doesn’t seem to be the main issue affecting our patient.

So, what's the important takeaway here? The choice that responsibly protects CC from harm is to address the use of ibuprofen without gastroprotection. Pharmacists and healthcare providers must engage in open conversations with patients about drug risks. Having protective measures, like prescribing a proton pump inhibitor alongside NSAIDs, can make a world of difference—talk about peace of mind!

Looking at CC's situation reminds us all of the essential role that pharmacy care plays in monitoring medication safety, which can sometimes feel like juggling flaming swords. Understanding potential drug therapy problems not only safeguards our health but also builds a bridge of trust between patients and healthcare providers.

Let’s be honest, navigating the world of medications isn't always straightforward. But with a bit of knowledge and open dialogue, we can get through it together. So whenever you come across a patient like CC, consider their medication stories, and remember: a proactive approach leads to a healthier tomorrow!