treat elevated cholesterolemia get help at
treat elevated cholesterolemia
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. treat elevated cholesterolemia
2. Include drug generic name, routes of administration, indication/uses, side effects, contraindications, drug interactions, food interactions, method of metabolism, method of excretion
3. Define and describe rhabdomyolysis
4. What is causing the rhabdomyolysis AND describe how /why it developed.
5. How can Mr T avoid this complication in the future? What adjustments can you make in his medications now? How can you advise him? treat elevated cholesterolemia
After six weeks Mr. T is back to normal. He has returned to taking his normal dose of simvastatin and his sinus infection is resolved. Mr. T wants to stop taking medications, exercise, lose weight and become a healthy individual. He decides to go on a grapefruit diet to lose 20 pounds. One week after starting the diet Mr T begins to suffer muscle aches and pains and a darkening of his urine. He demands to be taken off his medication because he feels it is causing these problems. treat elevated cholesterolemia
1. Why have Mr. T’s symptoms returned?
List 8 factors that can affect drug bioavailability.
Explain the term ‘first-pass effect’ and give examples of two drugs that undergo significant first-pass effect.
identify three routes of drug administration that avoid ‘first-pass’ hepatic effects.