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Canagliflozin - Marnie Brown Pharmacology Case Study Assessment Answer
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Her medical history reveals that she has a family history of Type II diabetes mellitus and developed gestational diabetes during each pregnancy which seemed to resolve after the births. She didn’t want to come here today as last time she came to the clinic she was admitted to hospital and she was clearly afraid that this might happen again. On further questioning, it was revealed that she was hospitalised to investigate the severe abdominal pain that she complained of. This was found to be due to polycystic ovary disease and she was referred to an endocrinologist, who also diagnosed her with early stage Type II diabetes.
She was referred to a nutritionist and an exercise physiologist but did not attend either appointment. Marnie indicates that her diet is poor as she has not been interested in home cooking a great deal since the birth of her 9-month-old daughter, whom she continues to nurse. The birth coincided with her partner leaving.
She has indicated that she is not always inclined to take her medication and comply with treatment, as she is not always convinced that the medications are working effectively and has frequently complained that ‘they give me a dry mouth, they make me dizzy and I feel terrible most of the time’. Sometimes ‘the pain of everything is too unbearable and I just want to stay in my bed forever’. She has noticed that ‘when her grandmother and mother come around and we drink lots of tea I can feel better’. Grandma says ‘it’s because tea has special powers!’
Her medical records reveal the medications she is currently taking:
canagliflozin 100 mg daily
ethinyl estradiol/norethindrine daily as directed
clotrimazole cream prn
Using your developing patient assessment and clinical decision-making skills, and drug knowledge analyse Marnie’s current situation. Brainstorm the factors that will facilitate quality use of medications and potentially enhance health and quality of life for Marnie.
Marnie Brown Pharmacology Case Study Assessment Answer
TASK: Marnie Brown is a 27-year-old Aboriginal single mother with 3 young children from a previous relationship. She has been driven to the clinic by her mother who found her “in bed with crying and hungry kids. Marnie never neglects her kids”. Marnie is co-operative but does not make a lot of eye contact with you and is not forward with the conversation. You also get the feeling that things are not right for her at the moment. Since her relationship breakup 12 months ago, she has put on a considerable amount of weight even though she has taken up smoking again to keep her ‘away from food’. Her physical examination can be summarised as follows:| Assessment/Examination | Results |
| Blood pressure | 100/65 mm Hg |
| Pulse rate | 86 bpm |
| Respiration rate | 29/min (deep and rapid) |
| Body Temperature | 38.0?C |
| Appearance | Agitated, dry skin. Red itchy patches under breasts and abdominal skin folds. |
| Breath | Sweet, fruity odour |
| Height | 1.75 m |
| Weight | 105 kg |
| Urine dipstick test – glucose | +++ |
| Urine dipstick test – nitrites | +++ |
| Current medication | Paracetamol and ibuprofen for pain |
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