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1.4.1: Techniques for effective communication/documentation of the development, implementation, and assessment of individualized treatment plans to patients and/or patients' agents

DL is a 19-year-old woman who calls you and states that she forgot to take her Desogen (EE 30 ?g/0.15 mg desogestrel) tablets for the last 2 days. She states that she is in her second week of the cycle. Which of the following is the most appropriate recommendation for DL?

(A) DL should take two tablets the next day and use a backup method for 7 days

(B) DL should continue taking her tablets as scheduled and use a backup method for 7 days

(C) DL should discard her pill pack and start a new one, use a backup method for 7 days

(D) DL should take two tablets for 2 days and use a backup method for 7 days

The Correct Answer is: D

Since DL is taking a 30 ?g EE COC, if two tablets are missed, a backup method should be used for 7 days and two tablets for 2 days should be taken (D). EC may also be used if unprotected intercourse occurred within the last 5 days.

DL should not be advised to take two tablets just the next day (A), continue taking her tablets as scheduled (B), or discard her pill pack and start a new one (C).

Topic: Contraception

AJ is a 41-year-old male with a new diagnosis of depression. He presents to your pharmacy for a refill of his sertraline. AJ wants to discuss his medication with you. He is tolerating the medication; however, he cannot tell a difference in the way he feels over the two weeks he has been on therapy. Past medical history includes dyslipidemia, depression, and osteoarthritis. Medications include pitavastatin, sertraline, and acetaminophen. What counseling points should be discussed with AJ?

(A) Sertraline is not indicated for depression. It is indicated for generalized anxiety disorder.

(B) Sertraline may take up to 8 weeks to see a benefit.

(C) Sertraline will produce an effect within two weeks. Your provider needs to consider another antidepressant.

(D) Sertraline has a drug interaction with your osteoarthritis medication, leading to reduced sertraline levels.

The Correct Answer is: B

Improvement can occur within the first 2 weeks of drug therapy, but it may take 4-8 weeks (B) to achieve substantial benefit. Sertraline is indicated for treatment of major depression (A). Additional uses of sertraline include obsessive compulsive disorder, panic disorder, post-traumatic stress disorder, premenstrual dysphoric disorder, and social anxiety ...

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