Shadow Health Pharm John Larsen Patient Case 1
(Answered)
"What is this?";
Let the patient know which medication you are giving & what it is intended to treat. -
ANSWER Model Response: This is lisinopril, which you are getting to help control
your high blood pressure.
"I guess I'm not supposed to take this with food. Is that right?";
This is an opportunity to teach the patient whether this medication should be taken
with food. - ANSWER Model Response: Lisinopril can actually be taken with or
without food, whatever fits your routine best. What is most important is to take this at
the same time everyday.
"Is it okay to take this with the blood thinner they're giving me?";
Inform your patient whether there is an interaction between these drugs. - ANSWER
Model Response: I'm glad you asked. There is no interaction between these drugs,
so it's okay to take them together. It's actually very important to keep your high blood
pressure well controlled while you are receiving blood thinners like warfarin and
enoxaparin, which means you'll want to keep taking your lisinopril regularly while you
are on those medications.
"So, this is the Lipitor then?";
Let your patient know about the generic medication he is receiving. - ANSWER
Model Response: Yes, this is atorvastatin, which is the generic name for lipitor. I'm
giving it to you to help keep your cholesterol levels under control.
"So, I just keep taking this stuff and it'll do it's magic for my cholesterol, huh?";
This is an opportunity to educate your patient on the lifestyle adjustments he can
make to improve the desired outcomes of this medication. - ANSWER Model
Response: To manage your cholesterol levels effectively, it is important to work on
this in your lifestyle too. Having a regular exercise regimen, eating a diet that is low
in fats, carbohydrates, and alcohols, and not smoking can help this medication do its
job.
Mr. Larson's general practitioner advised him to take 2g of fish oil per day. The
capsules Mr. Larson purchased are 1,000mg. How many fish oil capsules should he
take each day? - ANSWER 2g x (1,000 mg/ 1 g) x (1 capsule/ 1,000 mg)
, = 2 capsules per day
Before his surgery, Mr. Larson was taking tramadol, prescribed as 50 mg by mouth
every 6 hours as needed for pain. If he took it every available dose in a 24-hour
period, how many mg tramadol would he ingest? - ANSWER 24 hours x (1 dose/ 6
hours) x (50 mg/ 1 dose)
= 200 mg tramadol
While in the hospital, the orders call for Mr. Larson to take atorvastatin 20 mg, 1
tablet, by mouth once a day. However, the pharmacy only has 10 mg tablets. How
many tablets of atorvastatin should be administered to him? - ANSWER (20 mg/ 1
day) x (1 tablet/ 10 mg)
= 2 tablets atorvastatin per day
While in the hospital, the orders call for Mr. Larson to take lisinopril 10 mg, 1 tablet,
by mouth once a day. The pharmacy only stocks 5 mg tablets of lisinopril. How many
tablets of lisinopril should be administered to him? - ANSWER (10 mg/ 1 day) x (1
tablet/ 5 mg)
= 2 tablets lisinopril per day
The Davis's Drug Guide reports a potential drug-drug interaction with acetaminophen
and warfarin. If a patient is taking warfarin, more than 2 g/ day of acetaminophen
may increase bleeding. Because Mr. Larson is ordered both, he should receive no
more than 2 g/ day of acetaminophen.
If Mr. Larson takes acetaminophen 325 mg, 2 tablets, by mouth every 4 hours for
mild pain, what is the maximum number of tablets you can give him so that he
doesn't exceed 2 g/ day? (Assume you will only give him whole tablets) - ANSWER 2
g x (1000 mg/ 1 g) x (1 tablet/ 162.5 mg)
= 12.3 → 12 tablets per day;
Error on key: 2 g x (1000 mg/ 1 g) x (1 tablet/ 325 mg)
= 6.15 → 6 tablets per day
At 0800, Mr. Larson reports a moderate pain level of 5, and so you administer
oxycodone 5 mg/ acetaminophen 325 mg, 1 tablet, by mouth. At 1200, Mr. Larson
reports mild pain rated 3, so you administer acetaminophen 325 mg, 2 tablets, by
mouth. At this point, how much acetaminophen has Mr. Larson taken? - ANSWER
Dose 1 = 325 mg acetaminophen x 1 tablet = 325 mg acetaminophen
Dose 2 = 325 mg acetaminophen 2 tablets = 650 mg acetaminophen;
325 mg + 650 mg
(Answered)
"What is this?";
Let the patient know which medication you are giving & what it is intended to treat. -
ANSWER Model Response: This is lisinopril, which you are getting to help control
your high blood pressure.
"I guess I'm not supposed to take this with food. Is that right?";
This is an opportunity to teach the patient whether this medication should be taken
with food. - ANSWER Model Response: Lisinopril can actually be taken with or
without food, whatever fits your routine best. What is most important is to take this at
the same time everyday.
"Is it okay to take this with the blood thinner they're giving me?";
Inform your patient whether there is an interaction between these drugs. - ANSWER
Model Response: I'm glad you asked. There is no interaction between these drugs,
so it's okay to take them together. It's actually very important to keep your high blood
pressure well controlled while you are receiving blood thinners like warfarin and
enoxaparin, which means you'll want to keep taking your lisinopril regularly while you
are on those medications.
"So, this is the Lipitor then?";
Let your patient know about the generic medication he is receiving. - ANSWER
Model Response: Yes, this is atorvastatin, which is the generic name for lipitor. I'm
giving it to you to help keep your cholesterol levels under control.
"So, I just keep taking this stuff and it'll do it's magic for my cholesterol, huh?";
This is an opportunity to educate your patient on the lifestyle adjustments he can
make to improve the desired outcomes of this medication. - ANSWER Model
Response: To manage your cholesterol levels effectively, it is important to work on
this in your lifestyle too. Having a regular exercise regimen, eating a diet that is low
in fats, carbohydrates, and alcohols, and not smoking can help this medication do its
job.
Mr. Larson's general practitioner advised him to take 2g of fish oil per day. The
capsules Mr. Larson purchased are 1,000mg. How many fish oil capsules should he
take each day? - ANSWER 2g x (1,000 mg/ 1 g) x (1 capsule/ 1,000 mg)
, = 2 capsules per day
Before his surgery, Mr. Larson was taking tramadol, prescribed as 50 mg by mouth
every 6 hours as needed for pain. If he took it every available dose in a 24-hour
period, how many mg tramadol would he ingest? - ANSWER 24 hours x (1 dose/ 6
hours) x (50 mg/ 1 dose)
= 200 mg tramadol
While in the hospital, the orders call for Mr. Larson to take atorvastatin 20 mg, 1
tablet, by mouth once a day. However, the pharmacy only has 10 mg tablets. How
many tablets of atorvastatin should be administered to him? - ANSWER (20 mg/ 1
day) x (1 tablet/ 10 mg)
= 2 tablets atorvastatin per day
While in the hospital, the orders call for Mr. Larson to take lisinopril 10 mg, 1 tablet,
by mouth once a day. The pharmacy only stocks 5 mg tablets of lisinopril. How many
tablets of lisinopril should be administered to him? - ANSWER (10 mg/ 1 day) x (1
tablet/ 5 mg)
= 2 tablets lisinopril per day
The Davis's Drug Guide reports a potential drug-drug interaction with acetaminophen
and warfarin. If a patient is taking warfarin, more than 2 g/ day of acetaminophen
may increase bleeding. Because Mr. Larson is ordered both, he should receive no
more than 2 g/ day of acetaminophen.
If Mr. Larson takes acetaminophen 325 mg, 2 tablets, by mouth every 4 hours for
mild pain, what is the maximum number of tablets you can give him so that he
doesn't exceed 2 g/ day? (Assume you will only give him whole tablets) - ANSWER 2
g x (1000 mg/ 1 g) x (1 tablet/ 162.5 mg)
= 12.3 → 12 tablets per day;
Error on key: 2 g x (1000 mg/ 1 g) x (1 tablet/ 325 mg)
= 6.15 → 6 tablets per day
At 0800, Mr. Larson reports a moderate pain level of 5, and so you administer
oxycodone 5 mg/ acetaminophen 325 mg, 1 tablet, by mouth. At 1200, Mr. Larson
reports mild pain rated 3, so you administer acetaminophen 325 mg, 2 tablets, by
mouth. At this point, how much acetaminophen has Mr. Larson taken? - ANSWER
Dose 1 = 325 mg acetaminophen x 1 tablet = 325 mg acetaminophen
Dose 2 = 325 mg acetaminophen 2 tablets = 650 mg acetaminophen;
325 mg + 650 mg
