A 73-year-old man was admitted from an outside facility for evaluation of a small bowel obstruction. Pertinent medical history includes Crohn disease, type 2 diabetes mellitus, multiple abdominal surgeries, tachycardia, hypotension, acute pancreatitis, and anemia (hemoglobin 7.5 mg/dL). The patient’s nutritional status was evaluated, and he was initiated on total parenteral nutrition (TPN), together with a continuous infusion of regular insulin to run concurrently with the TPN infusion. On day 2 of therapy, the nurse held the TPN when the patient became febrile, but the insulin infusion was continued. The patient became unresponsive, with blood glucose of 22 mg/dL (normal 70–110 mg/dL). Dextrose 50% solution (25 g) was administered. Within 15 minutes, blood glucose rebounded to 141 mg/dL, and the patient became more alert and oriented. The pharmacist covering the floor notified the resident physician of the event and completed a hospital medication event report. During patient care rounds the following morning, the attending physician learned of the event and called for an immediate review of the case. As the pharmacist covering the unit, you are asked by the attending physician to coordinate the activities of the meeting because the event involved a medication. What steps are necessary in effectively managing this medication error and the resulting ADR? Use drug information resource to identify the ADRs and drug interactions present? Discuss and present solutions to the case?
A 73-year-old man was admitted from an outside facility for evaluation of a small bowel obstruction. Pertinent medical history includes Crohn disease, type 2 diabetes mellitus, multiple abdominal surgeries, tachycardia, hypotension, acute pancreatitis, and anemia (hemoglobin 7.5 mg/dL). The patient’s nutritional status was evaluated, and he was initiated on total parenteral nutrition (TPN), together with a continuous infusion of regular insulin to run concurrently with the TPN infusion. On day 2 of therapy, the nurse held the TPN when the patient became febrile, but the insulin infusion was continued. The patient became unresponsive, with blood glucose of 22 mg/dL (normal 70–110 mg/dL). Dextrose 50% solution (25 g) was administered. Within 15 minutes, blood glucose rebounded to 141 mg/dL, and the patient became more alert and oriented. The pharmacist covering the floor notified the resident physician of the event and completed a hospital medication event report. During patient care rounds the following morning, the attending physician learned of the event and called for an immediate review of the case. As the pharmacist covering the unit, you are asked by the attending physician to coordinate the activities of the meeting because the event involved a medication. What steps are necessary in effectively managing this medication error and the resulting ADR?
- Use drug information resource to identify the ADRs and drug interactions present?
- Discuss and present solutions to the case?
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