Case Study

WD is an 86 yo F who is seen by the internal medicine physician because she has been feeling very depressed. The physician takes a full history from WD, which reveals that several medications have been prescribed to her by a variety of specialists. It seems that each specialist neglected to pay attention to the meds that WD was prescribed by her other doctors and the potential drug-nutrient interactions.

The physician’s notes are as follows:

Current Medication Reason for Prescribing

St. John’s wort WD read in a magazine that this helps with depression

Slow Fe (iron supplement) prior anemia

Warfarin history of embolic stroke

Omeprazole history of embolic stroke

Tums upset stomach

Amoxicillin recent respiratory infection

Doxazosin incontinence

Allegra seasonal allergies

Lipitor high cholesterol

Vitamin E she heard it was “good for heart disease”

Diet hx

B- eggs D- cooked spinach

bacon chicken breast

orange juice mashed potatoes

fruit cocktail

L- Italian hoagie (salami, ham, cheddar cheese, lettuce, and tomato) iced tea

-What in WD's diet or medication history is of particular concern to the physician due to several reported drug interactions and potential to decrease effectiveness of medications?

Question

Case Study

WD is an 86 yo F who is seen by the internal medicine physician because she has been feeling very depressed. The physician takes a full history from WD, which reveals that several medications have been prescribed to her by a variety of specialists. It seems that each specialist neglected to pay attention to the meds that WD was prescribed by her other doctors and the potential drug-nutrient interactions.
The physician’s notes are as follows:
Current Medication	Reason for Prescribing
St. John’s wort	WD read in a magazine that this helps with depression
Slow Fe (iron supplement)	prior anemia
Warfarin	history of embolic stroke
Omeprazole	history of embolic stroke
Tums	upset stomach
Amoxicillin	recent respiratory infection
Doxazosin	incontinence
Allegra	seasonal allergies
Lipitor	high cholesterol
Vitamin E	she heard it was “good for heart disease”
Diet hx
B- eggs	D- cooked spinach
bacon	chicken breast
orange juice	mashed potatoes
fruit cocktail
L- Italian hoagie (salami, ham, cheddar cheese, lettuce, and tomato) iced tea

-What in WD's diet or medication history is of particular concern to the physician due to several reported drug interactions and potential to decrease effectiveness of medications?

Quizplus · Accepted Answer

St. John's wort can interact with several medications, including warfarin, omeprazole, doxazosin, and allegra, potentially decreasing their effectiveness and increasing their side effects. The use of Fe supplements, Tums, and prescription for Lipitor do not have reported interactions with WD's current medications or diet. St. John's wort can interact with many medications, including warfarin, omeprazole, doxazosin, and allegra, leading to decreased effectiveness or increased side effects. It should be avoided in patients who are taking multiple medications. The use of Fe supplements and Tums may also interact with some medications, but there is no indication in this case study that it is a significant concern. Lipitor is a commonly prescribed medication for high cholesterol and would not be of particular concern in this case.