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PHAR6205 Pharmacology
Question:
Relationship of calcium and Vitamin D:
1. What is the importance of the calcium supplement based on Ms. Johnson’s diagnosis of osteoporosis?
2. What is the relationship of calcium and Vitamin D?
Levothyroxine Dosage:
3. What is the average recommended dosage for Mrs. Johnson based on her diagnosis and age? Is her dosage within this range? Mrs. Johnson says she took her levothyroxine and calcium both with breakfast. The nurses the rehab facility has changed the time for the levothyroxine dosage to 6 am and the calcium/vit D dosage to 1 pm and 5 pm.
Ferrous Sulfate:
4. Why were these changes made? How does calcium affect the absorption of levothyroxine? How would that affect thyroid levels? (think pharmacokinetics) Mrs. Johnson is also prescribed Ferrous sulfate 325 mg daily for iron deficiency anemia. Her hemoglobin is 9.6.
Hemoglobin Level:
5. What is the normal hemoglobin level?
6. The doctor orders an additional supplement of Vitamin C 500 mg to be taken with Ferrous sulfate. What is the relationship between Vitamin C and iron?
Patient Education:
What foods interfere with iron absorption? What should you tell her about some of the common side effects that might occur while taking iron?
8. Considering the other medications that Mrs. Johnson is on – When would be the best time of day to take the Ferrous sulfate and Vitamin C. Provide your rationale. Two weeks into Ms. Johnson’s rehab stay she develops a urinary tract infection. The doctor prescribes Levaquin (levofloxacin) 500 mg daily for 5 days. Along with this antibiotic the doctor prescribes Florastor® one capsule twice daily.
9. Why was the Florastor prescribed? After recovering from the UTI, the doctor orders cranberry extract 300 mg one caplet daily.
10. What is the purpose of taking cranberry at this time? How does it work? Mrs. Johnson has made good progress and is going home taking the following supplements –
A. Ferrous sulfate 325 mg po once daily and Vitamin C 500 mg po once daily
B. Calcium 600 mg /Vitamin D 400 units po twice a day (combination tablet) cranberry 300 mg po once daily.
C. She is continuing her medications –
1. Levothyroxine 75 mcg po once daily
2. Furosemide 40 mg po once daily
3. Potassium chloride XR tablet 20 mEq once daily
11. What is the importance of taking the potassium chloride while taking Furosemide?
12. Potassium chloride comes in a 20 mEq extended release tab. When teaching Ms. Johnson about taking this supplement, what important information should you include?
13. Can Ms. Johnson purchase the potassium chloride dose ordered as an OTC supplement? Explain
14. What laboratory blood test should be monitored while she is on potassium supplement? What are the normal values?
15. Based on what you learned by completing this case study, suggest a medication schedule that could help Mrs. Johnson take her medications correctly to maximize absorption and bioavailability.
PHAR6205 Pharmacology
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