‫المملكة العربية السعودية‬

KINGDOM OF SAUDI ARABIA ‫وزارة التعليم‬

Ministry of Education ‫جامعة األميرة‬
‫نورة بنت عبدالرحمن‬
Princess Nourah bint
(048)
Abdurrahman university
(048)

College of
‫كلية الصيدلة‬
Pharmacy

Case #1

Group #: Group 1 (9p1)

Group Razan Bin Humaid 437000543

Asma Alfaouri 437000600
members: Ghadah Abdullah Alotaibi 437000278
Alanoud ahmed bahumied 437000555
Lama Abdullah AlRukban 437000461
Najla Tariq Alhowail 435004191

This case will be discussed in class to reinforce material outlined in readings and objectives. Following

the case is an outline of the therapeutic thought processes as it relates to the patient. Be prepared to

ACTIVELY discuss the case in class

Chief Complaint:
PD is a 51-year-old female who presents to her primary care doctor complaining of a painful,
swollen right knee.
History of Present Illness:
PD states that the pain and swelling began ‘quite some time ago, maybe more than 4 months
ago.” Since then, she has experienced intermittent pain in the knee and hip. She now reports
moderate morning stiffness lasting about 15 minutes in her hip and knee and similar stiffness
1
OSTEOARTHRITIS- CPP 426
DR. KHLOOD
2020
 ‫المملكة العربية السعودية‬
KINGDOM OF SAUDI ARABIA ‫وزارة التعليم‬
Ministry of Education ‫جامعة األميرة‬
‫نورة بنت عبدالرحمن‬
Princess Nourah bint
(048)
Abdurrahman university
(048)

College of
Pharmacy

after sitting for long periods. Her pain increases significantly when she first begins to walk but
dissipates after a few minutes of activity.
She fears that she will fall as occasionally her knees feel weak. She notes that the pain
intensifies when the weather is damp.
PMH:
Asthma x30+ years; HTN x7 years
Family History: Mother alive with Type-2 DM, HTN, and CHF, she had similar aches and
pain. Father deceased from MI at age 70.
Social History: Hair stylist. Denies tobacco use. Drinks alcohol socially (a couple glasses of
wine) on the weekends. Regular caffeine intake (1 cup of coffee a day).
Medication History:
 Albuterol 2p qid prn
 Salmeterol 2p bid prn
 Triamcinolone 4p bid
 Lisinopril 10mg qd
 Ibuprofen 400mg q6 prn (uses occasionally, when the pain is severe)(Prempro®0.625/2.5
qd; D/C 9 months ago)
Allergies: Sulfa- severe rash

2
OSTEOARTHRITIS- CPP 426
DR. KHLOOD
2020
 ‫المملكة العربية السعودية‬
KINGDOM OF SAUDI ARABIA ‫وزارة التعليم‬
Ministry of Education ‫جامعة األميرة‬
‫نورة بنت عبدالرحمن‬
Princess Nourah bint
(048)
Abdurrahman university
(048)

College of
Pharmacy

Physical Exam:
 GEN: Well developed obese female slightly anxious, but otherwise in NAD
 VS: BP 136/86; HR 80; T 37; RR 18; Wt 92kg; Ht 5’1”
 CHEST: Good breath sounds bilaterally; clear to A & P
 ABD: Soft, NT/ND, positive BS
 GU: Not preformed; patient refused exam
 RECT: Not preformed; patient refused exam
 EXT: Hip/ knee; limited range of motion, patellar crepitus, tenderness of the right knee
and hip. Right knee is warm and visibly enlarged. Nodes on distal interphalangial joint.
 NEURO: A&O x3; reflexes bilaterally equal
Labs: Not available

QUESTIONS:

3
OSTEOARTHRITIS- CPP 426
DR. KHLOOD
2020
 ‫المملكة العربية السعودية‬
KINGDOM OF SAUDI ARABIA ‫وزارة التعليم‬
Ministry of Education ‫جامعة األميرة‬
‫نورة بنت عبدالرحمن‬
Princess Nourah bint
(048)
Abdurrahman university
(048)

College of
1. What other information would you like to have?
Pharmacy
Liver function test , radiology to see if any is present (osteophytes, bony enlargement)
2. What is the desired treatment outcomes (goals) for PD’s OA?

1.Educate the patient, family members, and caregivers

2. Relieve pain and stiffness

3. Maintain or improve joint mobility

4. Limit functional impairment

5. Maintain or improve quality of life

3. List the signs and symptoms that have been identified as undesirable?
Signs: patellar crepitus, right knee warmth & enlargement, nodes on distal interphalangial
joint, tenderness of right knee and hip.
Symptoms: intermittent pain in the knee and hip, morning stiffness lasting 15 min, pain
increase while sitting and when weather is damp.
4. Which of the patient's symptoms are consistent with OA?
Symptoms:
pain in the knee and hip ,morning stiffness lasting 15min, pain increases while sitting and
when weather is damp, crepitus

Which of the patient's risk factors are consistent with OA?

Age 51

Obesity her BMI 38

4
OSTEOARTHRITIS- CPP 426
DR. KHLOOD
2020
 ‫المملكة العربية السعودية‬
KINGDOM OF SAUDI ARABIA ‫وزارة التعليم‬
Ministry of Education ‫جامعة األميرة‬
‫نورة بنت عبدالرحمن‬
Princess Nourah bint
(048)
Abdurrahman university
(048)

College of
Female sex
Pharmacy
Long standing (hair stylist )
5. Discuss non-pharmacological strategies to manage PD’s OA?

Lifestyle modification: patient education, support , regular exercise, physical therapy and
occupational therapy, weight loss.

Assisting devices like splinting, heat or cold compress

6. If therapy is indicated, what would you consider the pharmacological treatment(s) of

choice for PD?
Acetaminophen 500-1000 mg QID scheduled not exceed 4 g/ day
Or
Topical NSAIDs (Diclofenac 1% gel, Apply 4 g of 1% gel to affected area 4 times daily 
) if acetaminophen fail to reduce symptoms
9. What monitoring is necessary? If so, what and how often?
Symptoms relieve, liver function annually because alcohol may increase risk of liver toxicity

5
OSTEOARTHRITIS- CPP 426
DR. KHLOOD
2020
 ‫المملكة العربية السعودية‬
KINGDOM OF SAUDI ARABIA ‫وزارة التعليم‬
Ministry of Education ‫جامعة األميرة‬
‫نورة بنت عبدالرحمن‬
Princess Nourah bint
(048)
Abdurrahman university
(048)

College of
Pharmacy

End of the Questions

6
OSTEOARTHRITIS- CPP 426
DR. KHLOOD
2020