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Case Study Closer Look at a Medication Regimen Background History NB is a 40 year old 5 foot 7 inch 148 lbs 67kg African American female admitted through the emergency department ED with loss of consciousness possibly related to a drug overdose Subsequently she was transferred to the medicalsurgical floor with a medical diagnosis of renal failure and rhabdomyolysis due to immobility and cocaine Her histories were ascertained from her boyfriend Past medical history includes liver disease and renal insufficiency Past surgical history is unknown She is allergic to penicillin PCN with a reaction of hives Psychosocially she lives in an inner-city apartment with her boyfriend and has no children She has a history of heavy alcohol use and poly-substance abuse specifically alcohol heroin cocaine and marijuana There is no use of herbal remedies or tobacco but occasional use of a multivitamin The patients regular medication regimen is unknown due to the patients sedation and the boyfriends ignorance In addition a history of present illness was unable to be determined for the same reason It is suspected that her liver disease stems from chronic alcoholism Her rhabdomyolysis has been linked to her immobility and cocaine usage Laboratory results Her initial laboratory results included an elevated CPK and tested positive for cocaine opiates and benzodiazepines Whether these results are from prescribed medications or illicit drug use is unknown Most recently her laboratory values included Na2 138 K 42 Cl- 100 CO2 28 Ca2 98 CPK 197 BUN 15 CRE 11 and blood glucose 105 All of which are within normal levels with the exception of the CPK and CO2 being slightly high Myers 15-21 Numerous medications have been prescribed since her admittance one month ago with the most current ones listed in the Appendix Medications Heparin Although the patient was not admitted with any signs of thrombosis she became increasingly susceptible to their development as her hospital
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