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Mastering pharmacy case studies.

Introduction

If you are training to become a pharmacist, you will have had experience with pharmacy case studies. But why are pharmacy case studies so important?

As a qualifying pharmacist, case studies bring together the threads of study over the past four years. This includes your study of subjects such as:

• Pharmacology
• Pharmaceutical chemistry
• Pharmaceutics
• Clinical pharmacy practice

In practice, pharmacists are expected to draw on this knowledge and clinically apply it where necessary. These subjects feed into one another where knowledge of one subject became necessary to advance in a second subject and so forth. University staff overseeing the course structure put that structure together with these factors in mind. Pharmacy case studies are an important component, often toward the end of your pharmacy degree, that aim to establish the most relevant details that play a role in the career of a qualified pharmacist.

Case studies give pharmacy students an opportunity to test their understanding of a specialist topic. This may be anything from the formulation and dosing of medicines; to a drug’s mechanism of action, drug interactions, and clinical appropriateness for a medicine in a given scenario for a patient with specific factors to keep in mind. Evidently, this takes practice. There are many possible case study scenarios to consider. It can be difficult to always get things right.

Case studies are, then, a special kind of barometer through which we measure the professional competency of pharmacy students .

That is why pharmacy case studies are popular in degree programs – forcing students to think critically about a given topic – whether it be blood diagnostics, epidemiology, treatment options, or drug monitoring – tying together their past year’s study and how to apply this knowledge to (potentially) real-life situations.

Below, we’ve put together an introductory case study to provide you with a clear example of what kinds of questions can be asked and how best you should approach each question. With enough practice, clinical case studies become that much easier. And with time, students learn to enjoy case studies – as they are often your first direct experience of learning real and relevant facts that have an impact on your long-term professional career.

Pharmacy Case Study – Osteoporosis

A 49-year old woman with osteoporosis has been taking Fosamax for 6-months. She visits her GP complaining of acid reflux and pain radiating down her esophagus.

• What is the active ingredient of Fosamax?
• What is the mechanism of action of this medicine?
• Suggest a reason why this patient is taking Fosamax.
• How should the GP respond to the patient’s symptoms?
• What foods and/or medicines should the patient avoid?

Explanation

The questions ask more about the medicine – how it works, what it’s indicated for, how the GP should respond to patient symptoms and what interactions, from both food and drug sources, the prescriber and pharmacist must consider.

A – The active ingredient of Fosamax is alendronate; a bisphosphonate drug.

B – Alendronate works by inhibiting osteoclast-mediated bone resorption (the process whereby bone is broken down and minerals are released into the blood).

C – As a 49-year old woman, the patient is likely post-menopausal. Bisphosphonates are routinely prescribed to prevent osteoporosis in these patients.

D – The patient may be improperly administering the medicine. Patients who do not follow the correct protocol of administering bisphosphonates are likely to experience specific symptoms, particularly relating to the esophagus and GI tract. Patients should be counseled to take the medicine in the morning on an empty stomach, whilst remaining upright, and taken with a full glass of water. This eases the bisphosphonate through the digestive tract without irritating the esophageal wall. Patients should avoid taking and food or medicines, both before and for at least 30-minutes after taking the bisphosphonate.

E – Two groups of medicines should be avoided. First, NSAIDs should be avoided; as they increase the risk of gastrointestinal side effects. Second, patients should avoid foods or supplements that contain multivalent ions such as magnesium, aluminum, or calcium. This category includes dairy products and antacids. As we learned above, bisphosphonates should be avoided with these medicines/foods for at least 30-minutes after the bisphosphonate has been taken (on an empty stomach).

Practice More Pharmacy Case Studies

The more pharmacy case studies you practice , the better prepared you are for the needs and demands that present during the licensing end of your pharmacy program. Pharmacy case studies help guide students through the must-know clinical facts about drugs and medicines; both theoretical and practical knowledge.

Clinical case studies are one of the ways in which students make the transition between an experienced, knowledgeable student and a clinical professional whose expertise can be trusted in the real world. Case studies bring pharmacy students to the next level. The more practice you put in, the better results you can expect as you progress through the licensing stage of your nascent career. That, in the end, is what matters.

That’s about it for our discussion of case studies! Check back to our pharmacy blog soon for more exclusive content to help you master the science of drugs and medicines and build your long-term career.

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Public Health in Pharmacy Practice: A Casebook - 2nd Edition

Jordan R Covvey, Duquesne University School of Pharmacy

Vibhuti Arya, St John’s University College of Pharmacy and Health Sciences

Natalie A. DiPietro Mager, Ohio Northern University Raabe College of Pharmacy

Copyright Year: 2021

ISBN 13: 9781942341840

Publisher: Milne Open Textbooks

Language: English

Formats Available

Conditions of use.

Learn more about reviews.

Reviewed by Elaine Beale, Pharmacy Technician Program Lead, Tidewater Community College on 11/1/22

This text is uniquely composed in that it covers many topics well, leaving the reader with much to ponder and apply to pharmacy practice. I have not seen a text like this previously and think it would make a great addition to any pharmacy or... read more

Comprehensiveness rating: 5 see less

This text is uniquely composed in that it covers many topics well, leaving the reader with much to ponder and apply to pharmacy practice. I have not seen a text like this previously and think it would make a great addition to any pharmacy or pharmacy technician program.

Content Accuracy rating: 5

The text appears to be accurate with a major focus on social consciousness, which some may perceive as bias, but I see as cutting edge. Hopefully, after discussion, readers who may have had different opinions can be enlightened and come together on some points.

Relevance/Longevity rating: 5

The text is very current and relevant. Using equity as opposed to equality in a number of sections brings to focus on the difference and how pharmacists have an opportunity to impact this. The topics covered were never addressed when I went to pharmacy school in the 1980s, although they were present then as now. Hopefully this text can bring some of these issues to light so that the pharmacy community can continue with forward progress.

Clarity rating: 5

Each section is very clear and any technical terminology is explained within each chapter. There is an included glossary and abbreviation section which can be referenced at the end of each section as well.

Consistency rating: 5

I find the text very consistent and appreciate the section showing related chapters in the text at the bottom of each section which really ties the chapters in nicely. Each chapter is different, yet laid out in the same format so that once you are accustomed to it you know just how to view each chapter.

Modularity rating: 5

This would be a great ancillary text. Each chapter covers an important concept that can be combined with others but also stands alone. One chapter could be interspersed in a class at intervals, leading to excellent discussions and learning outcomes. It offers a chance for students and instructors to use case studies and practice communication skills to cover so many interesting topics. It could also be used as a format for a discussion board.

Organization/Structure/Flow rating: 5

I like the organization because every chapter uses the same format. I knew where to look for what I wanted to see after reviewing the first couple of chapters and was not disappointed to find each one continuing in the same manner. This was a great way to organize various topics written by different authors.

Interface rating: 5

I had no trouble navigating and reading the text.

Grammatical Errors rating: 5

Correct grammar is very important to me and should be evident in any written material. I did not find any issues with the grammar in this text.

Cultural Relevance rating: 5

This text focuses on health equity and brings up some very current and needed subjects regarding this. Health care is not available in an equitable manner throughout the country and this stimulates thought about why that is and how we can begin to work in pharmacy to address these important issues.

I am very impressed with the focus on social consciousness. The sections are all very relevant. The way the book is organized leads to ease of updating since the format is so clear. Each chapter left me more aware and interested. There were extra resources as well as references that could be pursued. As opposed to a hard core learning experience, this text presents relevant topics, encourages thought and discussion and leads one to further discovery.

Table of Contents

• 1. An ounce of prevention: pharmacy applications of the USPSTF guidelines
• 2. Communicating health information: hidden barriers and practical approaches
• 3. Medication safety: to ‘error’ is human
• 4. Drawing the line: preventing sexually transmitted infections
• 5. Interprofessional collaboration: transforming public health through team work
• 6. HIV and hepatitis C co-infection: a double-edged sword
• 7. Ethical decision-making in global health: when cultures clash
• 8. Safe opioid use in the community setting: reverse the curse?
• 9. The ‘state’ of things: epidemiologic comparisons across populations
• 10. Saying what you mean doesn’t always mean what you say: cross-cultural communication
• 11. The cough heard ‘round the world: working with tuberculosis
• 12. More than just diet and exercise: social determinants of health and well-being
• 13. Deciphering immunization codes: making evidence-based recommendations
• 14. Getting to the point: importance of immunizations for public health
• 15. Smoke in mirrors: the continuing problem of tobacco use
• 16. Plant now, harvest later: services for rural underserved patients
• 17. Telepharmacy: building a connection to close the healthcare gap
• 18. Hormonal contraception: from emergency coverage to long-term therapy
• 19. From belly to baby: preparing for a healthy pregnancy
• 20. When disaster strikes: managing chaos and instilling lessons for future events
• 21. Anticipating anthrax and other bioterrorism threats
• 22. In the stroke of time: pharmacist roles in the management of cerebrovascular accident
• 23. Alcohol use disorder: beyond prohibition
• 24. Immunizing during a pandemic: considerations for COVID-19 vaccinations
• 25. Sweetening the deal: improving health outcomes for patients with diabetes mellitus
• 26. The hidden burden of hemodialysis: personal and economic impacts
• 27. Only a mirage: searching for healthy options in a food desert
• 28. Sex education: counseling patients from various cultural backgrounds
• 29. Harm reduction for people who use drugs: A life-saving opportunity
• 30. Digging deeper: improving health communication with patients
• 31. Equity for all: providing accessible healthcare for patients living with disabilities
• 32. Laying the foundation for public health priorities: Healthy People 2030
• 33. Staying on track: reducing missed immunization opportunities in the pediatric population
• 34. When love hurts: caring for patients experiencing interpersonal violence
• 35. Pharmacists and Medicare Part D: helping patients navigate their prescription benefits
• 36. Expanding the pharmacists’ role: assessing mental health and suicide
• 37. Bridging the gap between oncology and primary care: a multidisciplinary approach
• 38. A stigma that undermines care: opioid use disorder and treatment considerations
• 39. Deprescribing in palliative care: applying knowledge translation strategies
• 40. Let your pharmacist be your guide: navigating barriers to pharmaceutical access
• 41. Open-door policy: a window into creation, implementation, and assessment
• 42. PrEPare yourself: let’s talk about sex
• 43. Unexpected souvenirs: parasitic and vector-borne infections during and after travel
• 44. You say medication, I say meditation: effectively caring for diverse populations
• 45. The Sustainable Development Goals and pharmacy practice: a blueprint for health
• 46. Experiences of a Caribbean immigrant: going beyond clinical care
• 47. Medicine for the soul: spirituality in pharmacy
• 48. Uncrossed wires: working with non-English speaking patient populations
• 49. Unintended consequences of e-cigarette use: a public health epidemic
• 50. A toxic situation: the roles of pharmacists and poison control centers
• 51. Prescription for change: advocacy and legislation in pharmacy
• 52. Travel medicine: what you need to know before you go
• 53. A pharmacist’s obligation: advocating for change
• 54. The great undoing: a multigenerational journey from racism to social determinants of health

Ancillary Material

• Milne Open Textbooks

About the Book

This casebook, now in its second edition, is a collaboration of over 90 individuals with expertise and training in public health pharmacy. A total of 54 chapters are presented, covering a broad array of topics relevant to pharmacy applications of public health. These topics include, but are not limited to, cross-cultural care, health literacy and disparities, infectious disease, health promotion and disease prevention, medication safety, structural racism, advocacy/policy analysis, chronic disease, women’s health, rural health, travel medicine and more. The book is designed to allow educators/students to choose chapters of interest as they feel suited, as each chapter is independent from the others. Each chapter contains learning objectives and an introduction to the topic, followed by a case and questions. The chapter closes with commentary from the authors and patient-oriented considerations for the topic at hand.

About the Contributors

Jordan R Covvey , PharmD, PhD, BCPSAssociate Professor of Pharmacy AdministrationDuquesne University School of Pharmacy; Pittsburgh, PA

Vibhuti Arya , PharmDClinical ProfessorSt John’s University College of Pharmacy and Health Sciences; Queens, NY

Natalie A. DiPietro Mager , PharmD, MPHProfessor of Pharmacy PracticeOhio Northern University Raabe College of Pharmacy; Ada, OH

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Pharmacy Case Studies

An integral approach to pharmacy via a series of pharmacy cases.

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Pharmacy Case Studies helps students understand the application of therapeutics in clinical practice. It tests knowledge gained within the individual areas of law and ethics, pharmaceutics, pharmacology and pathology by examples, bringing together various areas taught on the degree course.

Case studies of increasing complexity tie in strands of learning from across the pharmacy curriculum. Scenarios include both community and hospital pharmacy situations, as suited to the disease and pharmaceutical care provision.

Each chapter contains five case studies with questions and answers increasing in complexity from those for first year students through to cases designed for fourth year/pre-registration level.

• Gastrointestinal • Cardiovascular • Respiratory • CNS • Infections • Endocrine • Obstetrics, Gynaecology and UTI • Malignant Disease • Nutrition and Blood • Musculoskeletal and Joint • Eyes • ENT • Skin • Immunological/vaccines • Liver Disease • Renal Diesase • Paediatrics • Elderly

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A bowel function disorder, irritable bowel syndrome (IBS) is very common problem that highly affects the quality of life of the patient. IBS may be diarrhoea predominant IBS (IBS-D), may be (IBS-C) constipation predominant IBS, and sometimes mixed bowel pattern (IBS-M) with both harden & loosen stools. Complications may include changes in bowel habits such as diarrhea or constipation, and pain in abdomen along with various symptoms including rectal urgency with diarrhea and abdominal bloating. Risk factors include age, anxiety, depression and adverse life Events. Prognostic techniques are colonoscopy and abdominal ultrasound. Different treatment strategies are used to treat various conditions experienced by individual patients. Drugs like antispasmodics, tricyclic antidepressants, 5-HT3 antagonists and probiotics are proved effective in this condition. Objective: The survey aimed to find out Awareness about Irritable Bowel Syndrome (IBS) among the pharmacy graduates of 3 rd to 5th professional Pharmacy. Method: A Cross sectional and random method was used to collect data from university students. Data was analyzed and represented in the form of tables and graph. Result: According to our survey, 74% students have basic information about IBS, 26% students have knowledge about the complications of IBS, 33% have knowledge about the risk factors of IBS, 7% have information about the prognosis of IBS and 53% students have knowledge about the treatment strategies of IBS. Conclusion: The overall awareness is very low in pharmacy graduate. Naveed et al__________________________________________________ ISSN 2393-8862 AJPP[1][3][2014] 069-075

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Case Studies in Pharmacy Ethics (3 edn)

Professor of Medical Ethics Emeritus and Senior Research Scholar

Director, Center for Health Policy and Ethics and Dr. C.C. and Mabel L. Criss Endowed Chair in Health Sciences

Medical Safety Clinical Pharmacist

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The third edition of Case Studies in Pharmacy Ethics presents a comprehensive series of cases faced by pharmacists that raise ethical issues, with chapters arranged in a manner that simultaneously presents the topics that would be covered in a course on ethical theory. After an introduction, the book is divided into three parts. The introduction takes up four basic issues in ethical theory: the source, meaning, and justification of ethical claims; the two major ways of determining if acts are morally right; how moral rules apply to specific situations; and what ought to be done in specific cases. Part I deals with conceptual issues. Chapter 1 presents a five-step model the pharmacist can use for ethical problem solving. Chapter 2 addresses identification of value judgments in pharmacy and separation of ethical from nonethical value judgments. Chapter 3 looks at where the pharmacist should turn to find the source of ethical judgments. Part II presents cases organized around the major principles of ethics: beneficence and nonmaleficence, justice and the allocation of resources, autonomy, veracity (dealing honestly with patients), fidelity (including confidentiality), and avoidance of killing. Part III presents cases organized around topics that present ethical controversy: abortion, sterilization, and contraception; genetics and birth technologies; and mental health and behavior control. The remaining chapters cover drug formularies and drug distribution systems; health insurance, health system planning, and rationing; pharmaceutical research; consent to drug therapies; and terminally ill patients. The book includes links to professional codes of ethics and a glossary.

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SIMILAR ITEMS (based on metadata)

Ethics in Pharmacy Practice: A Practical Guide

• © 2021
• Dennis M. Sullivan 0 ,
• Douglas C. Anderson 1 ,
• Justin W. Cole 2

School of Pharmacy, Cedarville University, Cedarville, USA

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• The only textbook on pharmacy ethics that gives clear guidance to pharmacists and pharmacy students
• Provides a normative approach to the ethics of pharmacy practice
• Emphasizes critical thinking in ethics, based on foundational principles
• Includes abundant clinical and policy case scenarios
• Many additional teaching resources, including chapter review questions, suggestions for further reading, and a comprehensive glossary
• Features a ‘Pandemic Update,’ with important ethical insights from the 2020-2021 worldwide coronavirus crisis

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About this book

This textbook offers a unique and accessible approach to ethical decision-making for practicing pharmacists and student pharmacists. Unlike other texts, it gives clear guidance based on the fundamental principles of moral philosophy, explaining them in simple language and illustrating them with abundant clinical examples and case studies. The strength of this text is in its emphasis on normative ethics and critical thinking, and that there is truly a best answer in the vast majority of cases, no matter how complex. The authors place high trust in a pharmacist’s moral judgment. This teaches the reader how to think, based on ethical principles, not necessarily what to think. This means navigating between the two extremes of overly theoretical and excessively prescriptive. The cogent framework given in this text uses the language of competing duties, identifying the moral principles at stake that create duties for the pharmacist. This is the balancing act of normative ethics, and of deciding which duties should prevail in a given clinical situation. This work presents a clear-cut pathway for resolving ethical dilemmas encountered by pharmacists, based on foundational principles and critical thinking.

Presents a clear-cut pathway for resolving the ethical dilemmas encountered by pharmacists, based on foundational principles and critical thinking.

Jon E. Sprague, RPh, PhD, Director of Science and Research for the Ohio Attorney General

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Table of contents (14 chapters)

Front matter, introduction.

Dennis M. Sullivan, Douglas C. Anderson, Justin W. Cole

Basic Ethical Theory

Human value and human dignity, clinical ethics in historical context, part i, clinical ethics in historical context, part ii, clinical ethics in historical context, part iii, pharmacy professionalism, reproductive ethics, ethics at the end of life – part i, ethics at the end of life – part ii, rights of conscience, vaccines, resource allocation, and unproven treatments, case studies and policy scenarios, genetic ethics and other cutting-edge issues, back matter, authors and affiliations, about the authors.

Dr. Dennis Sullivan is an emeritus professor of pharmacy practice at Cedarville University, Cedarville, Ohio. He received his MD from Case Western Reserve School of Medicine in 1978, after which he trained in general surgery, and served for two years of active duty in the U.S. Army at Fort Campbell, Kentucky. Dr. Sullivan worked for twelve years as a medical missionary, providing surgical care in Haiti and in the Central African Republic. From 1996 to 2019, he was a member of the faculty at Cedarville University. In 2004, he received his MA in bioethics from Trinity Graduate School in Chicago. He has taught human biology, pharmacy ethics, and pharmacy law. He directed Cedarville University’s Center for Bioethics until his retirement in 2019. He still teaches part-time at Cedarville and at Wright State University, and serves as an academic ethicist on two Dayton area ethics committees.

Dr. Douglas C. Anderson Jr. is a professor of pharmacy practice at Cedarville University, Cedarville, Ohio, and a Clinical Pharmacist Specialist in Primary Care for the INTEGRIS Health System in Oklahoma City. He received his B.S. Pharmacy in 1988 and Pharm.D. in 1992, both from the University of Oklahoma College of Pharmacy. He has also completed a Pharmacy Practice (PGY1) Residency at St. Anthony Hospital in Oklahoma City, and a Fellowship in Adult Medicine at the University of Oklahoma Health Sciences Center. As a clinician/scholar, Dr. Anderson’s areas of expertise include primary care/ambulatory care, anticoagulation and thromboembolic disorders, as well as cardiovascular risk reduction.

Bibliographic Information

Book Title : Ethics in Pharmacy Practice: A Practical Guide

Authors : Dennis M. Sullivan, Douglas C. Anderson, Justin W. Cole

DOI : https://doi.org/10.1007/978-3-030-72169-5

Publisher : Springer Cham

eBook Packages : Religion and Philosophy , Philosophy and Religion (R0)

Copyright Information : Springer Nature Switzerland AG 2021

Hardcover ISBN : 978-3-030-72168-8 Published: 17 June 2021

Softcover ISBN : 978-3-030-72171-8 Published: 18 June 2022

eBook ISBN : 978-3-030-72169-5 Published: 16 June 2021

Edition Number : 1

Number of Pages : XIV, 234

Number of Illustrations : 28 b/w illustrations, 2 illustrations in colour

Topics : Bioethics , Pharmacy , Theory of Medicine/Bioethics

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CASE STUDY 3–1

Common side effects would be included in all major compendia (e.g., Micromedex® 2.0, Clinical Pharmacology, or Facts & Comparisons) which would be a good initial search. In addition, some of the adverse effect specific resources (e.g., Meyler's Side Effects of Drugs) would be appropriate to consult for less common side effects.

CASE STUDY 3–2

There are a variety of resources that could be consulted for this information including the text Drugs in Pregnancy and Lactation or some of the major compendia (possibly, Micromedex® 2.0 or Clinical Pharmacology).

The resources classify levofloxacin as an agent with unknown safety, but likely to be safe.

In order to best answer this question, the requestor should determine if the disease state has other treatment options which have more data available and if the infant is receiving any formula supplementation.

CASE STUDY 3–3

The student might start a search for general information in a toxicology text such as Goldfrank's Toxicologic Emergencies. That could be followed with a search in Micromedex® 2.0 to find some general toxicology information; specifically the POISINDEX component of that resource would provide comprehensive information on this topic.

The student would do best to search using the generic name of the medication, in this case using chlorpheniramine.

CASE STUDY 3–4

In a case you are not familiar with a term, a general Internet search might be a good start to help streamline your search. An Internet search shows that AMDUCA stands for Animal Medicinal Drug Use Clarification Act of 1994. Knowing that the term refers to a specific piece of legislation, you would be prompted to consider searching the American Veterinarian Medical Association web page or Food and Drug Administration web page.

CASE STUDY 3–5

Since this would be an off-label use, there may be less data in the tertiary resources. In this case it is likely more efficient to do a search in the secondary resources. Medline is a good place to start.

Initially conducting a search with no restrictions/limits ensures that valuable information is not missed.

If the initial search yields a significant number of results, then a restriction to human clinical trials would be beneficial. When conducting this search, it is important to realize that the term female sexual arousal disorder has changed over time, so maybe a more general search for female sexual dysfunctions will give more responses. In addition, searching for the specific drug sildenafil will yield useful data, but expanding the search using the class of drugs will provide more data.

CASE STUDY 3–6

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