PBL 2??

Diambil dari LMS PBL-2 Prof. Haniki

PBL 2: “I Can’t Play My Sax!”

Trigger 1: SAM is a 60-year old Chinese man who came to a community pharmacy asking for a bottle of cough syrup. He said he has been coughing up sputum for a few days and that it was getting worse which disrupted his job as a saxophonist.

Questions:

1. What additional information should be obtained from Mr. SAM?
2. What general advice can you give to Mr. SAM at this point?
3. What are your treatment options for cough management?
4. What preparation(s) would you recommend and why?

Trigger 2: Two weeks later he came back to your pharmacy and informed you that he was hospitalized for four days due to an acute exacerbation of chronic obstructive of airway disease (COAD). He was advised by the hospital pharmacist to quit smoking, but preferred to discuss it with you since he noted that you are a certified smoking cessation service provider. His discharge medications include:

MDI Combivent® 2 puffs TDS

MDI Salbutamol 2 puffs PRN

T. Neulin® 250mg BD x 1/12

T. Ciprofloxacin 500mg BD x 1/7

Your tasks:

1. Counsel Mr. SAM regarding the above medications.
2. Identify the relevant therapeutic intervention needed, if any.
3. Provide the smoking cessation intervention for Mr. SAM.

Trigger 3: Few months later Mr. SAM came again and informed you that during his follow-up at the hospital, an attending physician added a tablet called Harnal OCAS® 400 mcg OD. He mentioned to you that it all started when his answered a questionnaire called IPSS at the hospital and obtained a score of 19. After further examinations, he was diagnosed as having benign prostatic hyperplasia (BPH). He was told that the medicine will help him with his prostate problem but asked you if the medicine can also improve his sex life. He confided that of late, he was experiencing inconsistent ability to achieve an erection.

Questions/tasks:

1. Is Harnal® OCAS the drug of choice for Mr. SAM?

2. Counsel Mr. SAM regarding BPH and Harnal® OCAS.

3. Obtain additional information from Mr. SAM regarding the possibility of erectile dysfunction (ED).

4. Provide brief advice and discuss treatment options for ED with Mr. SAM.