A 45 y/o male presents to your office to discuss the use of oral medication to treat of his fungal toenails but has heard that it can cause problems with the liver. While you explain to the patient that the liver is in fact a big filter where medications do pass through, what are some questions you should ask the patients about their past medical history to ensure that oral medication is an option for him? What lab tests are performed on the patient to see if they are a candidate for oral medication?

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
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### Case Study: Liver Health Assessment for Oral Antifungal Medication

**Patient Profile:**
- **Age/Gender:** 45-year-old male
- **Chief Complaint:** Seeking treatment for fungal toenails
- **Concerns:** Potential liver issues associated with oral antifungal medication

---

**Context:**

A 45-year-old male presents to your office to discuss the use of oral medication for treating his fungal toenails. He expresses concerns about potential liver problems associated with this treatment. 

While explaining to the patient that the liver acts as a major filter where medications are metabolized, it’s essential to gather pertinent information about his medical history to ensure that oral antifungal treatment is a safe option.

---

**Key Questions for Patient's Medical History:**

1. **Current Medications:** 
   - What medications are you currently taking, including over-the-counter drugs and supplements?

2. **Previous Liver Issues:**
   - Have you ever been diagnosed with liver disease or experienced liver problems?

3. **Alcohol Consumption:**
   - How often do you consume alcohol and in what quantities?

4. **Family History:**
   - Is there a family history of liver disease, such as hepatitis or cirrhosis?

5. **Medical Conditions:**
   - Do you have any existing medical conditions like diabetes, hypertension, or hyperlipidemia?

6. **Recent Symptoms:**
   - Have you experienced any symptoms such as jaundice (yellowing of the skin and eyes), dark urine, fatigue, or abdominal pain?

7. **Allergies:**
   - Do you have any known drug allergies, specifically to antifungal medications?

---

**Lab Tests for Liver Function Assessment:**

To determine if the patient is a suitable candidate for oral antifungal medication, the following lab tests may be performed:

1. **Liver Function Tests (LFTs):**
   - **Alanine Aminotransferase (ALT):** Measures enzyme levels indicating liver damage.
   - **Aspartate Aminotransferase (AST):** Similar to ALT, it helps assess liver health.
   - **Alkaline Phosphatase (ALP):** High levels can indicate liver, gallbladder, or bone issues.
   - **Bilirubin:** Elevated levels can indicate liver disease or bile duct problems.
   
2. **Complete Blood Count (CBC):**
   - Evaluates overall health and can detect a variety of disorders, including liver disease
Transcribed Image Text:### Case Study: Liver Health Assessment for Oral Antifungal Medication **Patient Profile:** - **Age/Gender:** 45-year-old male - **Chief Complaint:** Seeking treatment for fungal toenails - **Concerns:** Potential liver issues associated with oral antifungal medication --- **Context:** A 45-year-old male presents to your office to discuss the use of oral medication for treating his fungal toenails. He expresses concerns about potential liver problems associated with this treatment. While explaining to the patient that the liver acts as a major filter where medications are metabolized, it’s essential to gather pertinent information about his medical history to ensure that oral antifungal treatment is a safe option. --- **Key Questions for Patient's Medical History:** 1. **Current Medications:** - What medications are you currently taking, including over-the-counter drugs and supplements? 2. **Previous Liver Issues:** - Have you ever been diagnosed with liver disease or experienced liver problems? 3. **Alcohol Consumption:** - How often do you consume alcohol and in what quantities? 4. **Family History:** - Is there a family history of liver disease, such as hepatitis or cirrhosis? 5. **Medical Conditions:** - Do you have any existing medical conditions like diabetes, hypertension, or hyperlipidemia? 6. **Recent Symptoms:** - Have you experienced any symptoms such as jaundice (yellowing of the skin and eyes), dark urine, fatigue, or abdominal pain? 7. **Allergies:** - Do you have any known drug allergies, specifically to antifungal medications? --- **Lab Tests for Liver Function Assessment:** To determine if the patient is a suitable candidate for oral antifungal medication, the following lab tests may be performed: 1. **Liver Function Tests (LFTs):** - **Alanine Aminotransferase (ALT):** Measures enzyme levels indicating liver damage. - **Aspartate Aminotransferase (AST):** Similar to ALT, it helps assess liver health. - **Alkaline Phosphatase (ALP):** High levels can indicate liver, gallbladder, or bone issues. - **Bilirubin:** Elevated levels can indicate liver disease or bile duct problems. 2. **Complete Blood Count (CBC):** - Evaluates overall health and can detect a variety of disorders, including liver disease
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