Ms Miles HMR Case Scenario
HMR case – Part 2 further information gathered
|Current medications according to patient|
|Medication||Dose (according to patient)||Purpose/comments (according to patient)|
|Telmisartan 40 mg||One with dinner||Blood pressure|
|Aspirin 100 mg||One second daily at dinner||Causes bruising|
|Alendronate 70 mg||One each Sunday||Bones|
|Spiriva Handihaler 18 mcg||One daily||Asthma|
|Escitalopram 20 mg||One nocte||For her mood|
|Temazepam 10 mg||One prn (about 1/week)||To get back to sleep|
|Mylanta 2go tablets||Chews one prn for nausea||Has 2-3 / day|
|Symbicort TH 200/6 mcg||One bd and prn (uses an extra dose most days now)||Asthma|
|Additional test results/information from GP|
|Contact with the GP reveals previous pathology (see below), this is all that is available at this time. A brief discussion with the GP reveals he increased her escitalopram dose following her hospital discharge, in anticipation of the stress such an event would have on her.
8 months ago
• TSH 3 (0.4-4.00 mU/L)
• T4 14 (11-25 pmol/L)
• Ferritin 115 (15-200 mcg/L)
• Iron 20 (7.0-27.0 µmol/L)
|Consider the patient needs or concerns, medication-related problems and medication management issues.
Part 2 A
Based on the information provided, identify potential and actual medication-related and disease-related problems, and patient concerns. Suggest how these could be addressed and/or monitored.
Write a letter or report to the referring GP, outlining your key findings for this patient and your suggestions or recommendations.