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At this time,
hr IV was discontinued, including IV ciprofloxacin. Oral ciprofloxacin 250mg Q12h was
started to complete the 14-day course of therapy. Oral potassium supplementation was
restarted at 10mEq PO BID. Oral digoxin 0.125mg QAM and hydrochlorothiazide 50mg
QAM were also started. A repeat CBC revealed the WBC count was down to 8.5 X 103 . The
patient was transferred to her bed in the nursing home, where periodic serum digoxin,
potassium, and creatinine levels were done with all levels within normal limits.
The consulting pharmacist had known this patient for the previous eight years, which
coincided with the time AAA had been in the nursing home. The relationship was one of
mutual trust, respect, and cooperation.
The pharmacist had a detailed database on AAA which was routinely updated when
the pharmacist made monthly rounds to review pharmacotherapy and more frequently when
AAA had changes in health status. This database consisted of objective patient-specific data,
including relevant physical findings (e.g., vital signs and sensorium status), laboratory data
(e.g., complete blood chemistries, serum digoxin levels, stool occult blood tests, urine and
paired blood specimens for culture and sensitivity, and CBCs),
Long-Term Pharmaceutical Care
Ciprofloxacin No crystalluria
No interstitial nephritis
No reduced renal function
Hydrochlorothiazide No edema
No hypokalemia
Satisfactory blood pressure for this patient, i.e., (120-140)/(75-90)