Pharmacology Case Study

Mr. AF is a 58 year old male with a past medical history of atrial fibrillation, hypertension, osteoarthritis, hyperlipidemia and early COPD.  He is an accountant, married, with 2 grown children.  He reports that he continues to smoke 1/2 pack of cigarettes per day.  He presents to the Emergency Department with a chief complaint of cough and upper respiratory congestion.

Medications:

Warfarin 4 mg daily

Hydrochlorothiazide 25 mg po daily

Lisinopril 20 mg po daily

Atorvastatin 10 mg po daily

Acetaminophen 325 mg po twice daily as needed.  

Current lab work:

WBC 13,000, Hgb 15, HCT 45, BUN 14 Cr 1.2 Na 145 K. 3.2 INR 2.3

Chol 253  HDL 42  LDL 160 Triglycerides 300

Vital Signs

BP 150/96, P 92, R 18, Temp 100.2   CXR:  + Infiltrate Right lower lobe

The ED Provider has ordered Levofloxacin 500 mg po daily for 7 days.

1.  Discuss and describe the indication, mechanism of action, side effects and patient education related to all of the patient’s current medications and the new prescription Levofloxacin

2.  Discuss the patient’s vital signs and include any additional questions which you would ask the patient. 

2.  Review the lab/CXR results and discuss any concerns/abnormal results. 

3.  Please provide the patient with education related to warfarin and levofloxacin. 

4.  Provide any additional patient education which is required.