Malapo, Jaqueline Nicole L.

PH106 2BSPh1

ACTIVITY 3

Instruction: Read the scenario and state what could be the problem why the patients experience such
side effect. What can the Pharmacist do to avoid such incident.

Case No. 1 . Patient R.A returns to your pharmacy complaining of side effects evidently caused by his new
medication. The patient's prescription indicated that he was given 30 nitroglycerin patches about 1 month
ago. Both the pharmacist and the physician told him to "apply one daily" . You ask him, "What seems to be
the problem?" He states, "I don't feel to good and I am running out of room" and then opens his shirt to
reveal 25 nitroglycerin patches firmly adheres to his chest!"

Answer:

In this Case scenario, we can tell the reason why the patient is suffering from such side effects. It is because
of the reason that the patient did not clearly understood the instruction given by both the pharmacist and
physician. It was evident in the patient’s body that the nitroglycerine patch that should be only used for
one day was still in the chest of patient for almost a month. According to MedlinePlus, Transdermal
nitroglycerine is usually applied once a day, worn 12 to 14 hours, and then removed. Nitroglycerine may
no longer work as well after you have used them for some time. The patient is experiencing unprecedented
side effect because he did not remove the patches that have already stayed on his chest for 12 to 14 hours.
Those patches should have been removed already in the first place but he didn’t, and now he’s suffering
the consequences of his actions. The blame cannot be given to the patient because his wrong doing was
only just a result of the pharmacists’ or physician’s unclear instructions to him. The pharmacist/physician
might have not mentioned to the patient about removing the patch and sticking only one patch for not
more than a day. In order to avoid such incident from happening again, the pharmacist should ensure that
proper counseling should be done and instructions to the patients should be clear, detailed and complete
before dispensing medications to the patient. Pharmacists could also inform the patients that if they are
unsure on how to take the medications and such unwanted side effects happen, the patients shouldn’t be
scared to immediately talk to them. Pharmacists should maintain a healthy and open communication during
counseling to ensure that the well-being of their patients wouldn’t be at risk.

Case No. 2 Patient C.Y a 11-month-old baby is admitted to the hospital with a severe infection. You, the
pharmacist, speak with the mother upon admission and learn that about 1week ago, her son had developed
a minor bacterial infection and received an antibiotic. The mother stopped giving her baby the antibiotic
after 4 days of therapy (instead of 7 days) because it appeared that the infection was cured. When you
asked her why she stopped the antibiotic, the mother stated that she was just following the directions on
the prescription label: “Take 1mL three times a day for infection until all gone.” The mother stated that she
gave the medication until the infection was “all gone.”

Answer:
It is clearly stated in the case scenario to what caused the severe infection on the 11-month-old baby. It is
because of the negligence of the mother. The mother did not follow the course of therapy prescribed by the
physician wherein the baby should be given antibiotic for 7 days. Instead, when she observed that the baby
was feeling better earlier than expected, she stopped giving antibiotics after 4 days of therapy. With that, the
minor bacterial infection became severe, making the baby to become admitted in the hospital. Aside from that,
it seems that the mother misunderstood the direction written in the prescription. The prescription says to
Malapo, Jaqueline Nicole L. PH106 2BSPh1

“Take 1 mL three times a day for infection until all gone”. It means that the antibiotics should be given to the
patient 1 mL, three times a day until all the medicines are administered in the seven day period. Instead, the
mother mistakenly thought that she would only give the antibiotic to her baby when she feel that the infection
is all gone. Which is why she already stopped giving antibiotics on her baby after 4 days of therapy. In order to
avoid such circumstances from happening, me, as the pharmacist, will enlighten the mother or my patients
about the importance of fully taking antibiotics in the prescribed course of therapy. According to Dr. Egloff-Du,
there are two reasons why we need to take the full prescribed treatment of antibiotics. One is because our
healthcare provider selected the best treatment for us to become healthy again. Second is because of the
resistance of antibiotics in our body. I will inform my patients about the two reasons why antibiotics should be
taken throughout the course of therapy. I will enlighten them that completing the course of the treatment will
increase the chance of killing all the bacteria that is causing the infection because halting the treatment early
will allow a small portion of bacteria to remain in the body and will potentially strengthen, mutate, and develop
resistance. Not all patients have an idea about the ability of bacteria to develop resistance when antibiotics is
not administered correctly. So, the best way to do away from such circumstances is by thoroughly counseling
the patients not only about the medicine and its side effects, but also the importance of following the directions
written by their health care provider in the prescription and it’s possible risks when not properly complied.