RA is a 30 year old female that you recognize from your pharmacy. You see her lingering in the vitamin section today while waiting for a prescription refill, so you ask if there is something you can help her find. She says that lately she has felt cold, fatigued, and “run down” emotionally.
DRPs:
1) Effectiveness > Dosage too low > Drug Interaction
Interaction with calcium and levothyroxine. Assessment: patient is experiencing symptoms of hypothyrodism because of reduced bioavailability of levothyroxine. Resolution: Space out calcium and levothyroxine by 4 hours. Reassess TSH levels in 6-8 weeks to determine if you need to change the dose of levothyroxine.
2) Indication > Needs Additional Drug Therapy
subtherapeutic dosing/condition
Assessment: patients A1c is not at goal (<7% or 6.5% per ADA/AACE).
Recommendation: Patient should be initiated on a second medication such as a sulfonylurea, thiazolidinedione, or another alternative therapy. Recommend follow-up with doctor to assess.
3) Indication > Needs Additional Drug Therapy > Preventative Therapy
Assess immunization needs.
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