Applied Pharmacology Coursework
Part 2: Case Studies
Read the following three case studies and answer all questions:
A patient is taking Paroxetine and presents to A&E with tremor, tachycardia, hypertension
and high temperature. After a genetic screening, the variant CYP2D6*4 is identified. Discuss:
What is Paroxetine and how does it work (mechanism and clinical use)?
• What is the role of the CYP2D6 in the drugs’ metabolism in general?
• What is the metabolic pathway of Paroxetine and how is it affected by the genetic variant described in this case study?
• What is the resulting alteration in the blood levels of Paroxetine?
• What is the link between the altered blood levels of Paroxetine and the signs and symptoms reported (can you identify the syndrome)?
A 20 yo woman with history of poorly controlled asthma presents to the A&E with severe shortness of breath and audible respiratory wheezing. She has normal blood pressure but she is pale. She uses terbutaline inhaler when needed but now the inhaler isn’t helping
What emergency drug should be administered?
• Discuss: the indications, side-effects and mechanism of action of the proposed drug
• What long-term therapy should follow, after she is stabilized?
• Discuss: the indications, side-effects and mechanism of action of the proposed therapy for long-term management