Highlights
Case Study 1
Cheryl is a 55-year-old woman, who works long hours for a publishing company. She likes to have a couple of drinks when she gets home from work every night with the take-away meals she picks up on her way home. She loves her job as an editor, but finds it very stressful, and so, has taken to smoking cigarettes to help her relax. What started as a couple everyday has now become a packet a day. She has also increased her alcohol intake to 4 glasses of vodka every night as she has noticed that she no longer gets the same pleasurable feelings from a couple of glasses. Her friends have noticed that she stumbles quite often, forgets things, is moody and is flushed in the face almost all the time. When questioned about the amount she drinks, she denies excessive use.
In the last couple months, Cheryl has lost interest in many things she once enjoyed; dancing, going to the movies, and art class. She finds that she cries at the drop of a hat. She finds it difficult falling asleep at night, and so has started to drink more and more until she passes out. She has no energy to get up for work and wants to stay in bed all day. Her sister is worried she is relying too heavily on alcohol, and fears that she is starting to get short-term memory loss from the alcohol consumption. She forgot her brother’s birthday, an important work meeting, and what day of the week it was. She stops mid-sentence as she cannot find the right words to communicate her thoughts, and she is taking double the time to now complete a task. She is becoming very frustrated with herself and lashes out at the people around her. Her sister decides it is time to book an appointment with the GP to work out what has been going on with Cheryl.
At the medical clinic, the GP listens to all of Cheryl’s signs and symptoms. She prescribes a benzodiazepine (Xanax) and a selective serotonin reuptake inhibitor (Zoloft). She also prescribes an acetylcholinesterase inhibitor after carrying out physical, neurological, and cognitive tests. Cheryl is also given information on counselling and is referred to a counsellor to talk through her problems and help her with coping strategies.
Question 1/1. Identify one disease/condition Cheryl has and justify your answer.
Question 1/2. Using the disease/condition you have identified in Question 1/1, explain the link between the clinical manifestations of the disease and its pathophysiology.
Question 1/3. Discuss the benefits of administration of an SSRI in Cheryl’s condition. To get full marks, you must explain the pharmacodynamics and pharmacological effects of SSRIs and relate them to Cheryl’s clinical picture.
Question 1/4. Describe the effect of chronic alcohol consumption on liver function and explain its consequence on the distribution of water between the interstitial and intravascular compartments.
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