Directions (for all cases): For each of the scenarios below, answer the questions
below using clinical practice guidelines where applicable. Explain the problem and
explain how you would address the problem. If prescribing a new drug, write out a
complete medication order just as you would if you were completing a prescription. Use
at least 3 sources for each scenario and cite sources using APA format.
Each scenario should be about 250 words, excluding the references.
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Week 1 Cases
1. A 52-year-old man was recently discharged from the hospital following treatment
for atrial fibrillation. He was discharged on Warfarin 5 mg po q day and
Amiodarone 200 mg tid. His INR is 8.8. What interaction has occurred with these
2 medications? What changes in his medications would you make?
2. A 44-year-old woman is currently taking Glipizide and Phenytoin. She has a new
prescription for Ceftriaxone. All three medications are known to be highly protein
bound. What effect does protein binding have on drug availability? How would
you manage this patient’s medication?
3. Name two drugs that are highly affected by the first pass effect. As a prescriber,
what actions would you take in prescribing these drugs to counter the first pass
effect?
4. James is a 49-year-old male that was prescribed atenolol for his high blood
pressure. James states that he only occasionally takes the medication because
he does not like the side effects. What information would you provide to the
patient at his visit? How would you manage his medication?