Hey future clinical pharmacists!
let’s test your prescription analysis skills with a real case I observed during my hospital training.
Prescription:
Tab. Ciprofloxacin 500 mg – 1 tab BD × 5 days
Tab. Theophylline 400 mg – 1 tab BD
Syrup. Gaviscon – 10 mL TDS
Patient: 60-year-old male with COPD and gastric discomfort
Now, let’s break down the potential issues:
- Drug-Drug Interaction:
• Ciprofloxacin and Theophylline are known to interact → Ciprofloxacin inhibits the metabolism of Theophylline → ↑ Theophylline levels → toxicity risk (nausea, seizures, arrhythmia) - Age Concern:
• Elderly patient → ↓ hepatic clearance → monitor Theophylline levels carefully - Timing with Antacid:
• Gaviscon (antacid) may reduce absorption of Ciprofloxacin → advise proper spacing (e.g., 2-hour gap)
Ideal Action Plan:
1.Consider alternative antibiotic if possible.
2.Monitor serum Theophylline levels.
3.Space out Gaviscon and Ciprofloxacin doses.
4.ducate patient on signs of Theophylline toxicity.
Have you come across similar prescription-related challenges in your practice? What tools or apps do you use to detect interactions? Share your tips below!