back pain and “just not feeling good”

Case Study I

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A 45-year-old female presents to your clinic today with complaints of back pain and “just not feeling good”.  Regarding her back, she states that her back pain is a chronic condition that she has suffered with for about the last 10 years. She has not suffered any specific injury to her back. She denies weakness of the lower extremities, denies bowel or bladder changes or dysfunction, denies radiation of pain to the lower extremities and no numbness or tingling of the lower extremities. She describes the pain as a constant dull ache and tightness across the low back. She states she started a workout program about 3 weeks, and she is working out with a friend that is a body builder.

She states her friend suggested taking Creatine to help build muscle and Coenzyme Q10 as an antioxidant so she started those medications at the same time she began working out. She states she also takes Kava Kava for her anxiety and garlic to help lower her blood pressure. Past medication history includes: Type II diabetes since age 27, High blood pressure, Recurrent DVT’s Her other medications include: Glyburide 3 mg daily with breakfast, Lisinopril 20 mg daily and Coumadin 6 mg daily

1. What are your findings following reviewing this medication list? Explain concerns in detail. 2. Is there additional information you would obtain? If so, please discuss rationale.

3. What are your recommendations for managing this patient’s medications?

4. What are the components for educating the patient?

5. If your plan is to prescribe a medication/s, create a prescription and discuss, what are the important components necessary on the packaging or on the label?

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