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Case Study

Question 8

Multiple Choice

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?


A) the use of Fe supplements
B) her chronic use of Tums
C) prescription for Lipitor
D) her use of St.John's wort

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