Short case studies for clinical pharmacy and therapeutics - RHEUMATOID ARTHRITIS

[pharma5]

Dear All,

I would like to share short case studies for clinical pharmacy and therapeutics, to help you practice some of the questions which may come up during your time as a pharmacy student at the University.

If you find such case studies useful, please post your comments here and if you would like to see model answers please let me know.


RHEUMATOID ARTHRITIS CASE STUDY

Case overview
Mrs A is a 73 year old woman who was diagnosed with rheumatoid arthritis last month. She has now come to your community pharmacy with a prescription for Ibuprofen and sulfasalazine.

Case questions
1. What is rheumatoid arthritis and how is it diagnosed?

2. What are the main clinical features for rheumatoid arthritis?

3. What risk factors does this patient have for developing rheumatoid arthritis?

4. What are the goals of therapy when treating rheumatoid arthritis?

5. Describe the place of sulfasalazine in treatment of rheumatoid arthritis and explain it’s mode of action.

6. State the main side effects associated with sulfasalazine.

7. Why is sulfasalazine dose increased gradually?

8. What are the main counselling points for sulfasalazine?

Mrs A returns to your pharmacy three months later and explains that since she started taking the new medication, she has been experiencing stomach pains.

9. What do you think could be causing stomach pains?

10. What could be done to resolve this problem?

Six months later, Mrs comes back to your pharmacy once again. She explains that she did not notice any benefit from sulfasalazine.

11. What are the alternative treatments which could be used in rheumatoid arthritis and discuss the next suitable treatment which could be tried?

[Nik]

I hope this isn't a clever trick to get us to do your work for you ?

[pharma5]

I hope this isn't a clever trick to get us to do your work for you ?

It is not.

This case study was posted here with the view to help pharmacy students.
The model answers will be posted if anyone needs them.

[Nik]

Just checking - has been done in the past. How would you answer question 3 without knowing a bit more about this patient ?

[Asterix]

Just checking - has been done in the past. How would you answer question 3 without knowing a bit more about this patient ?

shes 73 that itself is enough nik

[crit care]

but that is a risk factor....you asked for risk factorS.....

[Nik]

shes 73 that itself is enough nik

Incidence in pre-menopausal women is greater than that in men. Post menopause, incidence is pretty much equivalent. Major risk factor is genetics, and there is also a link with smoking.