|
Post by goodness on Jan 25, 2016 14:49:58 GMT
Grace my patient with a blood clotting defect and is on coumadin (a blood thinner) just came to see me about the pain she has been having, asking about her choice to use Aspirin as a pain reliever. I explained to her how acetaminophen ( Ibuprofen) will be a better choice for her because aspirin combined with a blood thinner is potently dangerous as it increases her chances of internal bleeding because Aspirin inhibits clot formation by inhibiting thromboxane A2 a platelet aggregator.
P-Population 1.people with blood clotting defect 2.Bloodclotting defect patients on coumadin 3.bloodclotting defect patients on aspirin 4.Bloodclotting defect patients on coumadin and aspirin 5.Bloodclotting defect patients on Coumadin and ibuprofen
I-Intervention Intervention of interests include 1. Aspirin
C-Comparison Ibuprofen
O-Outcome 1. Prevention of internal bleeding
|
|
|
Post by sarasareen on Jan 25, 2016 23:55:03 GMT
A 25 year old female with a history of Bipolar I disorder presents to your office. She tells you that she has been taking Lamictal (Lamotrigine) and lithium therapy for several months. She reports a skin rash and insomnia. You suggest that you switch the patient to Depakote. You write her a prescription for Depakote (Valproate) and advise her that this drug will not give her the side effects of skin rash, and should ease the insomnia. Patient is advised to take the Depakote (Valproate) only at night with food. Patient is also recommended to go for regular liver function tests ( just as with Lamictal (Lamotrigine)). PICO
Population:
1. Individuals with Bipolar I disorder
Intervention:
1. Depakote (Valproate) + lithium 2. Lamictal (Lamotrigine) + lithium
Comparison:
In this case, the patient's side effects of insomnia and rash are linked to Lamictal use. Depakote is likely to induce drowsiness and should only be taken at night. Both drugs need to be monitored closely and liver function tests are advised.
Outcome: Patient achieved relief from symptoms of mania and depression and her insomnia and rash are relieved.
|
|