A1+Case+Study+2

=Case Study Two=

You are asked to undertake an HMR for a man in his early twenties who has a history of asthma and frequent migraine. His asthma is only mild and he very infrequently uses a Ventolin inhaler (three to four times a year). His migraines however have been getting worse and he now experiences them several times a week. Sumatriptan does help. He usually takes 100 mg at the onset of the headache and the dose sometimes needs to be repeated in an hour. The doctor is referring him for review because the man has now become depressed and he wants to start an antidepressant. Prior to starting the antidepressant he decides a HMR would be useful to understand how he is taking his medicines at home and what other medicines, over-the-counter or otherwise, he is taking.

You arrange to visit the man at home. At the time of the review his only prescribed medicine is sumatriptan.

He takes eight Panadeine-15 tablets almost every day and his usage has increased over the past few months. He previously did not take any regular analgesics. The frequency of his headaches has increased and they are present 'all the time now'. Previously he was using sumatriptan about once or twice a month and then he started using it weekly and now it is daily use. The increase in headaches coincided with increasing work demands. He indicated he had tried things from the health food store and over the past six months on a friend's advice.


 * **Hx** || **Date** ||
 * mild asthma || 1999 ||
 * Migraine || 2007 ||
 * Depression || 2008 ||
 * **Current Medications** || **Dose** ||
 * Imigran //sumatriptan// || 100 mg prn (maximum of 300 mg/day) ||
 * Panadeine-15 //paracetamol + codeine// || 1000/30 mg qid (maximum of 4 g paracetamol/day) ||
 * Panadeine-15 //paracetamol + codeine// || 1000/30 mg qid (maximum of 4 g paracetamol/day) ||

Problems

 * Current symptoms:**


 * Test results:**


 * Current Medications:**


 * Other problems:**

What to do

 * **Drug Related Problem** || **Current Treatment** || **Comments** ||
 * __1,__ ||  ||   ||
 * __2.__ ||  ||   ||
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 * __6.__ ||  ||   ||