Pharmacy Case Study

[Jas Atwal 27]

I needed help with the following case study. I can't figure out if its digoxin or bendroflumethiazide that is causing the symptoms or from some interaction. Can someone please help me figure this out? I appreciate any help I can get!!

Case 1

Mrs GT, aged 81, weight 55 kg.

Admitted to emergency room via doctor

PC: Nausea, vomiting, dizziness, visual disturbances

HPC: Symptoms have developed over the past 24 hours

DH:
bendroflumethiazide 2.5 mg om
digoxin 250 mcg od
ramipril 10 mg od
carvedilol 25 mg bd

What do you think are the most likely causes of Mrs GT’s symptoms? Explain why each of these causes is likely.

What do you think is the actual cause of Mrs GT’s symptoms?

What action would you, as the pharmacist, advise the medical team to take?

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[naseuy]

What are some objective and subjective AEs of digoxin? Of thiazides?

What are some possible interactions that may exacerbate the toxicity?

 

[Dred Pirate]

I love pharmacy students who are to lazy to do their own research and join this forum and ask someone to do their homework on their first post.

 

[rxlea]

Wtf no labs?

Whatever image you posted is not showing up for me.

 

[CynicalIntern]

It's lupus.

 

[Ackj]

why are they using dig and ramipril in their right eye?

 

[Dred Pirate]

why are they using dig and ramipril in their right eye?

lol - going out on a limb here and guessing this person is not from the US

 

[Ackj]

lol - going out on a limb here and guessing this person is not from the US

Bendroflumethiazide was a bit of a tip off, I suppose