The purpose of the Pharmacotherapy Casebook is to help students in the health professions and practicing clinicians develop and refine the skills required to identify and resolve drug therapy problems by using patient case studies. Case studies can actively involve students in the learning process; engender self-confidence; and promote the development of skills in independent self-study, problem analysis, decision-making, oral communication, and teamwork. Patient case studies can also be used as the focal point of discussions about pathophysiology, medicinal chemistry, pharmacology, and the pharmacotherapy of individual diseases. By integrating the biomedical and pharmaceutical sciences with pharmacotherapeutics, case studies can help students appreciate the relevance and importance of a sound scientific foundation in preparation for practice.
The patient cases in this book are intended to complement the scientific information presented in the 10th edition of Pharmacotherapy: A Pathophysiologic Approach. This edition of the casebook contains 157 unique patient cases, with case chapters organized into organ system sections corresponding to those of the Pharmacotherapy textbook. Students should read the relevant textbook chapter to become thoroughly familiar with the pathophysiology and pharmacotherapy of each disease state before attempting to make “decisions” about the care of patients described in this casebook. The Pharmacotherapy textbook, casebook, and other useful learning resources are also available on AccessPharmacy.com (subscription required). By using these realistic cases to practice creating, defending, and implementing pharmacotherapeutic care plans, students can begin to develop the skills and self-confidence that will be necessary to make the real decisions required in professional practice.
The knowledge and clinical experience required to answer the questions associated with each patient presentation vary from case to case. Some cases deal with a single disease state whereas others have multiple diseases and drug therapy problems. As a guide for instructors, each case is identified as being one of three complexity levels; this classification system is described in more detail in Chapter 1.
Casebook Section 1: Principles of Patient-Focused Therapy includes 11 chapters that provide guidance on use of the casebook as well as several patient cases for managing special patient populations (eg, pediatrics) and situations (eg, toxicology).
Chapter 1 describes the format of case presentations and the means by which students and instructors can maximize the usefulness of the casebook. A systematic approach is consistently applied to each case. The steps involved in this approach include:
Identifying real or potential drug therapy problems
Determining the desired therapeutic outcome(s)
Evaluating therapeutic alternatives
Designing an optimal individualized pharmacotherapeutic plan
Developing methods to evaluate the therapeutic outcome
Providing patient education
Communicating and implementing the pharmacotherapeutic plan
In Chapter 2, the philosophy and implementation of active learning strategies are presented. This chapter sets the tone for the casebook by describing how these approaches can enhance student learning. The chapter offers a number of useful active learning strategies for instructors and provides advice to students on how to maximize their learning opportunities in active learning environments.
Chapter 3 discusses the importance of patient communication and offers strategies to get the most out of the time that the clinician shares with the patient during each encounter. The information can be used as the basis for simulated counseling sessions related to the patient cases.
Chapter 4 describes the patient care process and outlines the steps in creating care plans to help ensure that the drug-related needs of patients are met. Students should be encouraged to practice writing care plans when completing the case studies in this casebook.
Chapter 5 describes two methods for documenting clinical interventions and communicating recommendations to other healthcare providers. These include the traditional SOAP note and the more pharmacy-specific FARM note. Student preparation of documentation notes for the patient cases in this casebook will be excellent practice for future practice.
Sections 2 through 18 contain patient cases organized by organ systems that correspond to those of the Pharmacotherapy textbook. Section 19 (Complementary and Alternative Therapies) contains patient vignettes that are directly related to patient cases that were presented earlier in this casebook. Each scenario involves the potential use of one or more dietary supplements. Additional follow-up questions are then asked to help the reader gain the scientific and clinical knowledge required to provide an evidence-based recommendation about use of the supplement in that particular patient. Sixteen different dietary supplements are discussed: garlic, fish oil (omega-3 fatty acids), ginger, coenzyme Q10, butterbur, feverfew, St. John’s wort, kava, cinnamon, α-lipoic acid, black cohosh, soy, Pygeum africanum, glucosamine, chondroitin, and elderberry.
The focus of classroom discussions about the patient cases should be on the process of solving patient problems as much as it is on finding the actual answers to the questions themselves. Isolated scientific facts learned today may be obsolete or incorrect tomorrow. Healthcare providers who can identify patient problems and solve them using a reasoned approach will be able to adapt to the continual evolution in the body of scientific knowledge and contribute in a meaningful way to improving the quality of patients’ lives.
We are grateful for the broad acceptance that previous editions of the casebook have received. In particular, it has been adopted by many schools of pharmacy and nurse practitioner programs. It has also been used in institutional staff development efforts and by individual pharmacists wishing to upgrade their pharmacotherapy skills. It is our hope that this new edition will be even more valuable in assisting healthcare practitioners to meet society’s need for safe and effective drug therapy.