MSPharmacy-B
Concepts In Clinical Pharmacy
Case No. 1: TYPE 2 DIABETES MELLITUS
PATIENT PRESENTATION
CHIEF COMPLAINT:
“I was recently diagnosed with possible diabetes and would like to have my blood sugar
tested. I
...
MSPharmacy-B
Concepts In Clinical Pharmacy
Case No. 1: TYPE 2 DIABETES MELLITUS
PATIENT PRESENTATION
CHIEF COMPLAINT:
“I was recently diagnosed with possible diabetes and would like to have my blood sugar
tested. I think that my blood sugar is running low because I have a terrible headache.”
HISTORY
HPI:
Name: Sarah Martin
Age: 43 yrs old
Comes to the pharmacy for a diabetes education class taught by the pharmacist and
would like for the pharmacist to check her blood sugar before the class begins. She was
diagnosed with diabetes mellitus Type 2 about 6 months ago. She has been attempting
to control her disease with diet and exercise but has had no success. Her physician has
recently started her on glyburide 5 mg. She has gained 15 lb over the past year.She
monitors her blood sugar once a day, per her physician, with a range of 215–260 mg/dL.
Her fasting blood sugars average 170mg/dL.
PMH:
Type 2 DM × 6 months
HTN × 15 years
Bipolar disorder × 25 years
Dyslipidemia × 10 years
Morbid obesity × 15 yearsFH:
Father has history of hypertension and bipolar disorder
Mother has a history of dyslipidemia
Brother has DM secondary to alcoholism
SH:
Has been married for 21 years.
She has two children who are teenagers.
She works in a floral shop making deliveries.
Denies any use of tobacco products but does drink alcohol occasionally (five
beers/wine per week).
MEDICATIONS:
Glyburide 5 mg po BID -- 2nd gen sulphonyurea an antidiabetic
Lisinopril 20 mg po once daily -- ACE inh for HTN
Zyprexa 5 mg po Q HS -- Olanzapine: treatment of moderate to severe manic
episode
Carbamazepine 200 mg po TID -- Anticovulsant
Lorazepam 1 mg po TID PRN -- for anxiety
Fluoxetine 20 mg po Q AM EC -- antidepressant known as an SSRI (selective
serotonin reuptake inhibitor).
ASA 81 mg po once daily -- Antithrombotic
Pravastatin 40 mg po once daily – Dyslipidemia
ASSESSMENT:
The patient reports that she exercises at most once a week and her diet is difficult to
maintain due to the nature of her job as a delivery person. Her glycemic control has been
maintained with an 8.9% A1C 6 months ago. She has had a moderate weight gain of 15lb
(6.8 kg) over the past year. Her blood pressure and cholesterol are not at goal on the
current drug therapy. Her bipolar disorder is moderately controlled on the current drug
therapy. When the patient is in a depression or manic phase, she tends to use food to
“treat” the symptoms
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