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A 45-year-old female presents to your clinic today with complaints of back pain and “just not feeling well”. She states that her back pain is a chronic condition that she has suffered with for about 10 years. The pain does not radiate to the lower extremities. She denies traumatic injury to her back. She denies weakness, numbness, or tingling of the lower extremities. She denies bowel or bladder changes or dysfunction. She describes the pain as a constant dull. ache and tightness across the low back.
She states she started a workout program about 3 weeks, and she is working out with a friend that is a body builder. She states her friend suggested taking Creatine to help build muscle and Coenzyme Q10 as an antioxidant, so she started those medications at the same time she began working out. She states she also takes Kava Kava for her anxiety and garlic to help lower her blood pressure.
PMH: Type II diabetes since age 27, High Blood Pressure, Recurrent DVT’s.
Her other medications include: Glyburide 3 mg daily with breakfast, Lisinopril 20 mg daily and Coumadin 6 mg daily.
1. After reviewing the patient’s medication list, what are your findings? Explain concerns in detail.
2. Is there additional information you would obtain? If so, please discuss rationale.
3. What are your recommendations for managing this patient’s medications?
4. If your plan is to prescribe a medication/s, create a prescription based on the prescription format found on page 46, figure 4-2 of your pharmacology textbook.
5. What education would you provide for this patient?
Please be concise. You do not need to write long paragraphs to prove your points.

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