Pic: Case Study #15
Study Books Used in Class: 0
Lehne, R. A. (2013). Pharmacology for nursing care. New York: Elsevier Health Sciences.
Description: JT, a 45 year old Kellogg’s executive, complains of aches in his joints and a tightness in his chest. His medications include alprazolam (Xanax) 0.25mg
twice daily, zolpidem (Ambien) 1omg at bedtime, lisinopril (Prinivil) 2omg daily, and rosuvastatin (Crestor) 2omg at bedtime. His heart rate is 75, blood
pressure 130/95, HDL 35, LDL 140. He has no history of cardiac problems besides hypertension. He uses sildenafil 5omg as needed. Recently he has
complained of fatigue, saying his family has found him sleepwalking, during which time he drinks glass after glass of grapefruit juice.
The questions: 5
1. Which drug or drugs could contribute to the joint pain?
2. What is the condition known as rhabindomyolysis?
3. What are the cardiac implications of any of these drugs?
4. Are there any current concerns surrounding the use of zolpidem (Ambien)?
5. What should you recommend given these symptoms, and why?
6. What is the significance, if any, of the grapefruit juice?
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