Case Study: An Integrated Approach to The Treatment of Chronic Fatigue Syndrome A 21 year old girl had an upper respiratory tract infection, one month prior to coming for treatment. She was home for the Christmas Holidays from University. The upper respiratory tract infection was treated with Biaxin, 250 mg for one week Her acute symptoms had improved in terms of fever and chills, sore
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QuizDemographic and Administrative Information
Name (abbreviated): G.S.M.
Weight (kg): 90
Height (cm): 176 cm
Admission Date: 23/9/2011
Marital Status: widower
A.W.M., a 68 years old male is a known case of DM, HTN, A-fib, HF and IHD. He is admitted to the hospital complaining of shortness of breath and severe abdominal distension of one week duration and is diagnosed as a case of decompensated heart failure with ascitis and digoxin toxicity. The patient underwent paracentesis on 25/9/2011.
On admission the patient suffered from decompensated HF, subset II, and acute kidney Note: Upon the interview it appeared that A.W.M. took double the dose of digoxin and carvedilol because of his vision problem.
Diet: low salt diet
Physical Activity: Minimal
Smoking: Non smoker
The patient suffers frommoderate visionimpairment.
Chemistry and CBC
Tests and Procedures
Fasting Blood glucose
Review of Systems
General – conscious, oriented, sleepy, fatigued,
Eye-Ear-Throat: blurred vision
Dermatology –mild bruises
Respiratory: shortness of breath
Gastroenterology: nausea, vomiting and diarrhea
CV – freeAbd – Soft,non-distended; no massesor obvious tenderness,nausea, vomiting anddiarrhea.
Carvedilol 25 mg PO ½ x2 (since 3 months)
Digoxin 0.25 mg PO ½ x1 (since 3 months)
Amiodarone 200 mg PO 1x1 (since 2 weeks)
Current Drug Therapy
(held on 25/9)
(held on 23/9)
(held on 23/9,
Pharmacist care plan for current medications
Treatment Related Issue
Follow up and monitoring
1) What are the advantages and disadvantages of the new oral anticoagulant
dabigatran in comparison to warfarin?
2) Is it rational to replace amiodarone with the less lipophilic drondarone in
this patient? Justify your answer.
3) What are the advantages and disadvantages of the renin inhibitor
Aliskiren in comparison to ACEIs and ARBs in the treatment of
1. Full name (as in passport)______________________________
2. Age _____
3. Professional Degree ____________________________________
4. Institution ___________________________________
5. Country _________________________
6. E-mail address _________________
Prospettive del trattato Libia-Italia Il 3 febbraio è stato definitivamente approvato il disegno di legge che autorizza la ratifica del Trattato “ Amicizia, partenariato e cooperazione ” tra Italia e Libia, firmato a Bengasi il 30 agosto 2008. L’unica forza politica ad opporsi, al senato, sono stati i radicali; come c’era da aspettarsi, hanno fatto leva sulla solfa dei ‘diritti uman