Mr GB, a 78-year-old British Pakistani male, is a resident in a local care home. He had a fall in the care home 4 weeks ago and had to go to hospital where he had a hip replacement. He stayed in hospital for 10 days and was recently discharged back to the care home. His current medication is listed below. Aspirin 75mg tablet: 1 OD Omeprazole 20mg capsule: 1 OD Atorvastatin 20mg tablet: 1 ON Metformin 500mg MR tablets 1 BD Sitagliptin 100mg tablet: 1 OD Amlodipine 5mg tablets: 1 OD Salbutamol 100mcg CFC free inhaler: 2 puffs QDS Trimbow® inhaler: 2 puffs BD Carbocisteine 375mg capsule: 1 TDS Paracetamol 500mg tablet: 1-2 QDS PRN Sertraline 50mg tablets: 1 OD Zopiclone 3.75mg tablet: 1 ON PRN Cavillion® durable barrier cream: Apply to affected area PRN Past medical history Eczema (since 1982) Family history Mother diagnosed with angina at age 52 years Maternal grandfather died aged 80 years following a stroke Social history Does not consume alcohol Smoker – 30 pack years (20 cigarettes per day for 30 years) Retired construction worker Is married, wife aged 72-year-old and has 3 grown up children who visit him at weekends Observations today (taken by nursing staff in care home) Blood pressure 135/83 mmHg Weight 86kg Height 1.57m Normal bowel habit and urine output Difficulty swallowing solid dosage forms for the past 5 days the question Today, the prescribing pharmacist who works in the GP surgery has visited the care home to conduct a weekly round and review high priority patients. Mr GB has been highlighted by the nursing staff as in need of clinical review. Mr GB tells you that he made the decision to stop smoking. Justify which treatment option you would prescribe for Mr GB from the following; nicotine replacement therapy, varenicline or buproprion. Your answer should address each treatment option and discuss; give: Patient factors such as appropriateness of formulation Contraindications and cautions for use SPECIFIC to this patient’s history (including renal and hepatic impairment if needed to be considered) Potential adverse effects SPECIFIC to this patient’s history Relevant drug interactions
Mr GB, a 78-year-old British Pakistani male, is a resident in a local care home. He had a fall in the care home 4 weeks ago and had to go to hospital where he had a hip replacement. He stayed in hospital for 10 days and was recently discharged back to the care home. His current medication is listed below.
Aspirin 75mg tablet: 1 OD
Omeprazole 20mg capsule: 1 OD
Atorvastatin 20mg tablet: 1 ON
Metformin 500mg MR tablets 1 BD
Sitagliptin 100mg tablet: 1 OD
Amlodipine 5mg tablets: 1 OD
Salbutamol 100mcg CFC free inhaler: 2 puffs QDS
Trimbow® inhaler: 2 puffs BD
Carbocisteine 375mg capsule: 1 TDS
Paracetamol 500mg tablet: 1-2 QDS PRN
Sertraline 50mg tablets: 1 OD
Zopiclone 3.75mg tablet: 1 ON PRN
Cavillion® durable barrier cream: Apply to affected area PRN
Past medical history
Eczema (since 1982)
Family history
Mother diagnosed with angina at age 52 years
Maternal grandfather died aged 80 years following a stroke
Social history
Does not consume alcohol
Smoker – 30 pack years (20 cigarettes per day for 30 years)
Retired construction worker
Is married, wife aged 72-year-old and has 3 grown up children who visit him at weekends
Observations today (taken by nursing staff in care home)
Blood pressure 135/83 mmHg
Weight 86kg
Height 1.57m
Normal bowel habit and urine output
Difficulty swallowing solid dosage forms for the past 5 days
the question
Today, the prescribing pharmacist who works in the GP surgery has visited the care home to conduct a weekly round and review high priority patients. Mr GB has been highlighted by the nursing staff as in need of clinical review. Mr GB tells you that he made the decision to stop smoking. Justify which treatment option you would prescribe for Mr GB from the following; nicotine replacement therapy, varenicline or buproprion. Your answer should address each treatment option and discuss;
give:
Patient factors such as appropriateness of formulation
Contraindications and cautions for use SPECIFIC to this patient’s history (including renal and hepatic impairment if needed to be considered)
Potential adverse effects SPECIFIC to this patient’s history
Relevant drug interactions
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