Danya Bocarsly
Case Study #1
Patho-Pharmocalogy
Mr T is a 67 year old retired Navy veteran. He has been taking simvastatin for 2 years to treat elevated cholesterolemia. During a recent visit to a 24 hour acute care clinic in a local mall he was prescribed clarithromycin for an acute sinus infection.
Two days later Mr T arrives in the emergency room complaining of generalized muscle pain, muscle weakness and dark colored urine. Tests revealed myoglobin in the urine and a serum creatinine of 186 micromol/l (usual baseline for this patient was 90 micromol/l). A diagnosis of rhabdomyolysis is made.
1. Create a pharm card for each medication listed in the case. Include drug generic name, routes of administration, indication/uses, side effects, contraindications, drug interactions, food interactions, method of metabolism drug generic name routes of admin
Indication/
uses side effects contra-indications drug interactions food interactions method of metabolism method of excretion …show more content…
The contents of the broken-down muscle fibers can enter systemic circulation and cause acute renal failure, which can be fatal (Pharmacology for Nurses: A Pathophysiologic Approach 291).
3. What is causing the rhabdomyolysis AND describe how /why it developed.
Rhabdomyolysis can be caused by the interaction between the stain drugs and other medications such as macrolide antibiotics, azole antifungals, fibric acid agents and certain immunosuppressants. The mechanism of the interaction is not known but these different medications interact with the statin metabolism and lead to an increase risk for severe muscle breakdown or myopathy. The broken-down muscles then enter systemic circulation and case the rhabdomyolysis (Pharmacology for Nurses: A Pathophysiologic Approach 291).
4. How can Mr. T avoid this complication in the future? What adjustments can you make in his medications now? How can you advise