The value of case studies cannot be underestimated.

Case studies allow the student to learn the essential facts about a given topic – extracting the essential, clinical knowledge that adds relevance to their clinical career. When starting out, case studies are challenging. But they don’t need to be. With the right approach and enough practice, pharmacy case studies become insightful and quite enjoyable.

Over the past couple of years on social media, we’ve added thousands of facts. We’ve learned that students don’t want to get bogged down in unnecessary detail. Instead, they want the relevant facts– without the added depth of detail. Case studies bring you these facts in a different way, exploring the intricacies of how to approach clinical scenarios.

Case studies enhance your professional standing. You begin to think about cases from different angles and unique perspectives. You’re forced to think outside the box. Case studies bring together the body of knowledge you’ve been studying throughout your degree program – pharmaceutical chemistry to pharmacology to clinical medicine.

Case studies give you the opportunity to think like a professional. The more exposure you have to case studies, the better. By practicing pharmacy case studies, you begin to hone and refine your professional thinking. If you haven’t analysed a case study yet, we’ve added an introductory case study below – a cardiovascular-based study.

Study tips and tricks

When reviewing case studies, always bear the following factors in mind:

• The age of the patient
• Any pre-existing medical history
• What symptoms the patient experiences
• Medicines the patient is currently taking
• How the above factors are interrelated to one another

Instead of thinking about each factor separately, think about each factor as one part of a complex web system – interlinking components that impact upon each other. In other words, think of the case study from a holistic perspective. From there, you can think through, reflect upon and ultimately arrive at the correct conclusion.

Let’s take a few moments to review an introductory case study.

Introductory Case Study

A 70-year old man visits his local physician reporting chest pain. On subsequent review, his physician learns that his chest pain manifests when the patient applies effort – such as when he’s walking upstairs or when he’s lifting furniture.

What is the likely diagnosis for this patient?

With this diagnosis in mind, which of the following medicines is the most appropriate treatment option?

 

• Aspirin

• Atorvastatin

• Enalapril

• Sublingual nitroglycerin

• Metoprolol

 

Explanation:

The patient is experiencing stable angina.

Stable angina is also known as “effort angina”; a form of chest pain that arises on exertion. Examples of exertion include stress, cold weather and exercise. Pain usually subsides within a few minutes or after use of sublingual nitroglycerin.

From the treatment options available, metoprolol is the most appropriate choice.

Beta-blockers, of which metoprolol is a member, are first-line agents in the prevention of stable angina. Metoprolol has two functions – first, it reduces heart rate and myocardial contractility. In turn, this reduces the level of work the heart must perform and, consequently, reduces the amount of oxygen needed.

Sublingual nitroglycerin is used to relieve an acute attack of chest pain. It can also be used to reduce angina before exertion-based events, such as exercise. However, it is not as effective at preventing angina to the same extent as beta-blockers.

Some drugs in the list – such as enalapril, aspirin and atorvastatin – do not prevent angina. A statin may be prescribed to reduce risk of cardiac events. Patients with atherosclerotic disease may be prescribed an ACE inhibitor or aspirin to reduce the risk of recurrent cardiovascular events or death.

Other drug classes – such as calcium channel blockers (eg. nifedipine) and long-acting nitrates – may also be considered as alternatives to beta-blockers.

Correct answer – e) Metoprolol

Maximize Your Learning

The case study above requires you to understand:

• The difference between stable and unstable angina
• Symptoms and how best to diagnose those symptoms
• Analyse the suitability of medicines to meet this diagnosis

And that’s the fundamental essence of case studies.

Filtering your knowledge through the prism of case studies is what maximizes your professional learning.

PharmaFactz is a leading online resource that helps students get to grips with drugs and medicines; a passionate believer that, through applying yourself to case studies, you can come out the other end a more competent, knowledgeable healthcare professional.