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Pain and Fever Fall 2012 (1)

She presents at the community pharmacy you are

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She presents at the community pharmacy you are working at and asks for a recommendation of an OTC product for the frequent headaches she has been having 2-3 times per week. She states the headaches as being gradual in onset that lasts for about 1-2 hours. She describes the pain from her headaches as diffuse and bilateral, extending throughout her entire head. Her PMH is significant for asthma, and allergies include aspirin (hives). What do you recommend? A. Naproxen 220 mg, 1 tablet every 12 hours as needed B. Ibuprofen 200 mg, 1 tablet every 4 hours as needed C. Acetaminophen 500 mg, 2 tablets every 6 hours as needed D. Acetaminophen 325 mg, 2 tablets every 6 hours as needed E. Patient is not a candidate for self-treatment
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Case 2 LP is a 60 year old male with a PMH of liver disease caused by viral hepatitis, depression, and dyslipidemia. He presents to the pharmacy complaining of a 2 day history of body aches, chills and fevers ranging from 101.2-102.6 F based on his home oral temperature measurements. He thinks he got the flu from a co- worker. LP would like a recommendation for self-treatment for his fevers. What do you recommend? A. Aspirin 81 mg, 1 tablet daily B. Ibuprofen 200 mg, 1 tablet every 4 hours as needed C. Acetaminophen 500 mg, 2 tablets every 6 hours as needed D. Acetaminophen 325 mg, 2 tablets every 6 hours as needed E. Patient is not a candidate for self-treatment
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Case 3 LK is a 54 year old female with no significant PMH who is experiencing dull pain bilaterally in her knees and in her right hand. She cannot recall straining the joints, and denies excessive swelling or bruising. She has experienced similar pain in the past, which was generally relieved by rest and non-pharmacologic therapy. However, this time the pain has been severe, so she decided to self- treat with acetaminophen, which she has been using for the past 10 days. She comes into the pharmacy looking for advice about treatment, as her pain is interfering with her ability to function on a daily basis. What do you recommend for further treatment? A. Continue acetaminophen 500 mg every 6 hours as needed B. Switch to ibuprofen 200 mg every 4 hours as needed C. RICE therapy D. Topical camphor 3-4 applications/day E. Patient is not a candidate for self-treatment and should be triaged appropriately
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