Recommendations for Medication for Patients with Diabetes Case Study

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Pharmacology Case Study ScenariosScenario 1: Mark Johnson (72 years old, DVT Treatment with Warfarin)ProblemMark is on warfarin (5 mg daily) for Deep Vein Thrombosis (DVT) and has a history of hypertension, hyperlipidemia, and osteoarthritis. He is also taking HCTZ (25 mg daily), celecoxib (200 mg daily), fluvastatin (40 mg daily), and Goody\'s Powder (as needed for pain). There are potential drug-drug interactions between warfarin, celecoxib, and Goody\'s Powder (which contains aspirin). Additionally, Mark\'s warfarin dose might need adjustments due to his risk of bleeding, influenced by his concurrent medications and potential CYP2C9 polymorphism (Holail et al., 2022).Medication Adjustments1. Warfarin: Continue warfarin but closely monitor INR levels (target INR for DVT: 2-3) (McRae et al., 2021).· Prescription: Warfarin 5 mg po daily, #30 (30-day supply), 0 refills. Monitor INR in 3-5 days.2. Celecoxib: Discontinue celecoxib due to its interaction with warfarin, which increases the risk of bleeding.· Alternative: Acetaminophen 500 mg po q6h prn for pain.· Prescription: Acetaminophen 500 mg, #60 (15-day supply), no refills. Max 4g/day.3. Goody\'s Powder: Discontinue due to aspirin\'s interaction with warfarin, increasing the risk of bleeding.· Alternative: As above, acetaminophen for pain relief.4. HCTZ and Fluvastatin: Continue both, as they do not have significant interactions with warfarin.Impact of CYP2C9 PolymorphismA CYP2C9 polymorphism can reduce warfarin metabolism, increasing its effect and raising the risk of bleeding. In such cases, a lower starting dose of warfarin is recommended, and more frequent INR monitoring would be essential. Genetic testing for CYP2C9 variants may be considered to guide therapy (Duarte & Cavallari, 2021).MonitoringINR levels should be checked every 3-5 days until stabilized within the therapeutic range (2-3). Liver function and signs of bleeding (e.g., bruising, dark stools) should be monitored.ReferencesDuarte, J. D., & Cavallari, L. H. (2021). Pharmacogenetics to guide cardiovascular drugtherapy. Nature Reviews Cardiology, 18(9), 649-665.Holail, J., Mobarak, R., Al-Ghamdi, B., Aljada, A., & Fakhoury, H. (2022). Association ofVKORC1 and CYP2C9 single-nucleotide polymorphisms with warfarin dose adjustment in Saudi patients. Drug metabolism and personalized therapy, 37(4), 353-359.McRae, H. L., Militello, L., & Refaai, M. A. (2021). Updates in anticoagulation therapymonitoring. Biomedicines, 9(3), 262.Scenario 2: Pill Identifier (P 80)Medication IdentificationThe pill with imprint P 80, round, yellow, and scored is Atorvastatin 80 mg, used for lowering cholesterol levels (Surma et al., 2023).

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First-Pass EffectThe first-pass effect refers to the metabolism of a drug by the liver after oral administration, which reduces the amount of active drug reaching systemic circulation. For atorvastatin, the first-pass effect is…

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…K., Abdulrahim, J., Shah, N., Pagidipati, N. P., ... & Jones,W. S. (2020). Risk factor burden and long?term prognosis of patients with premature coronary artery disease. Journal of the American heart association, 9(24), e017712.Scenario 4: Sandra (55-year-old African American Female, Hypertension)ProblemSandra was prescribed Toprol XL (metoprolol succinate) 50 mg daily for hypertension but is non-adherent due to side effects. Her current blood pressure is 158/92 mmHg, above the target of

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