MN553 Advanced Pharmacology Unit 9 Case Study “Prescribed Drugs with CAMs”
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Advanced Pharmacology
MN553 Advanced Pharmacology
Unit 9 Case Study
“Prescribed Drugs with CAMs”
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MN553 Advanced Pharmacology Unit 9 Case Study “Prescribed Drugs with CAMs”MN553 Advanced Pharmacology Unit 9 Case Study “Prescribed Drugs with CAMs”MN553 A...
Case Study: MN553 Advanced Pharmacology
Unit 9 Case Study
“Prescribed Drugs with CAMs”
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Date of Submission
This paper addresses a pharmacological management plan for Mr. NX, including
consideration of possible contraindications for CAMs, prescriptive and non-prescriptive
recommendations for management of acute pain and other ongoing disease processes, followed
by evaluation strategies.
Pharmacological Management Plan
CAMs Contraindicated with Current Prescriptions and Diagnoses
Treating and managing acute pain comprises assessing its cause and then initiating both
pharmacological and non-pharmacological interventions. Usually, pharmacological management
includes the use of or administration of various medications that relieve pain such as ibrufen,
acetaminophen, among others. On the other hand, non-pharmacological treatment involves
numerous methods such as exercises, physical therapy, and a modified lifestyle.
According to Singh et al., 2012, complementary and alternative medicine (CAM) refers
to those drugs that are prescribed and administered to patients in certain particular conditions
when one type of drug fails to bring a positive outcome or unable to treat the underlying
condition. Usually, physicians prescribe CAMs to enhance management of the patient’s
condition, and they are typically prescribed after the doctor has done a thorough evaluation of the
patient, CAMs, and the side effects that the disease might have to the patients (American College
of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines, 2002). CAMs are effective
at improving disease management and yielding a positive patient outcome.
, However, there are some instances that they may be more harmful than beneficial to the
patient. And this is why the physician must evaluate the patient before initiating or prescribing
such complementary and alternation drugs. In the case study, Mr. NX has a history of three
conditions and acute pain which might be related to his underlying conditions. He has under
medication to control these conditions. For instance, he is receiving lisinopril 20mg daily to
manage hypertension. He is also receiving glyburide 3 mg daily to manage diabetes and
Coumadin 5mg daily for deep venous thrombosis.
There are various types of CAMs, and they are currently prevalent. About 15% of the
United States population is using CAMs every week. About 6% to 15% are using these
complementary and alternative drugs with other prescribed medications (Hashempur et al.,
2015). Most of these patients do not know the side effects or drug interactions that may result
from such combinations of drug use.
Some CAMs are contraindicated in certain prescription drugs. For instance, those CAMs
that have antiplatelet or anticoagulant effects like the willow bark and Ginko are contraindicated
for use with Coumadin, which is a type of warfarin.
The most at-risk patients are those patients that are taking Coumadin with a narrow
therapeutic window like the case study. CAMs such as St. John’s wort, cayenne, CoQ10, willow
bark, and ginger are linked to increased risk of bleeding such patients like Mr. NX. Another
CAM that is contraindicated with the Coumadin prescription is the chitosan. This is because this
CAM interferes with the absorption of vitamin K that affecting the half-life of Coumadin.
Mr. NX is using kava kava which is stated to alter the mechanism of action Coumadin
and result in its increase action and increased bleeding. Kava kava is contraindicated in this case
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