Monday, August 22, 2016

Applying my Education to Real Life

An update from Saliha Syeda:

It was my 2nd last day at rxBriefCase. I was almost done my placement and I had completed all my projects.  So, I starting working on other projects related to Obesity, and suddenly I get a phone call from a family member.  This phone call made me very nervous and worried - a family member was admitted to the hospital due to chest pain.   I will call this family member "AT."  I left early that day from rxBriefCase to go see AT.  When I reached the hospital, AT's vitals were stable, and they were waiting on blood work and final diagnosis from the doctor.

As we were waiting, I started to assess AT myself, and make my own conclusion about the incident.  When assessing AT, I realized AT's medications were not optimally managed. 

AT’s medical background: Diabetes, high blood pressure, and stent inserted due to previous heart blockage. 

I was thinking back to my rxBriefCase presentation which was on "Spotlight on SGLT2 inhibitors", and realized that AT should be on a SGLT2 inhibitor.  I wrote a letter to his family doctor mentioning the superior efficacy of this agent in those with diabetes and clinical cardiovascular disease.  

In terms of AT's chest pain, I mentioned:
    1. Doctor will probably ask why did you stopped Ramipril (a very important medication for patients with diabetes for heart and kidney protection) (AT mentioned cardiologist asked them to stop it because they were feeling dizzy)
    2. Rule in/out a mini stroke
    3. Determine if there was any heart abnormalities through ECG
When the doctor came back 5 hours later, they mentioned the same points.
    1. Doctor re-started ramipril at a lower dose for heart and kidney protection
    2. Ruled out mini stroke
    3. No heart abnormalities (both ECG and blood tests were normal)
In conclusion, due to normal blood test and ECG, they discharged AT with the diagnosis of chest pain.  In terms of the reason behind the incident, they were unable to find the cause.   The doctor did mention the importance of regularly taking medications, as AT’s medications are lifelong to help with his condition.  

The program that I took at rxBriefCase gave me knowledge about SGLT2 inhibitors as a class, as well as review the medical condition diabetes, and for that reason I was able to make an appropriate recommendation for AT.