Integrated Therapeutics Case Study
INSTRUCTIONS
Mrs. AH has continued the management strategy for another 2 years and developed macular degeneration, for which she has commenced Macu-vision tablets. Her GP has identified that she has Wet Age Related Macular Degeneration (AMD) and would like you to provide evidence supporting the use of Avastin (Bevacizumab).
Q3. Discuss the evidence supporting the use of Avastin in the management of Wet AMD. (350 words) (25 marks)
Mr. NM (68 years) was admitted to the critical care unit for the management of septic arthritis for a prosthetic knee joint. He was commenced on IV antibiotics and scheduled for a surgical washout of the knee in 48hrs. The patient also developed a Pulmonary embolism and commenced on a Heparin Infusion to maintain a target APTT level for the next 72hrs. The Heparin infusion was made up using a 10,000units/50ml as per the local protocol in the critical care unit and administered at a rate of 1000units/hr (5ml/hr). The heparin infusion was held 6 hrs prior to surgical washout of the knee. The patient underwent a surgical washout of the knee, and the heparin infusion was re-started after a successful washout. The patient had been transferred back to the critical care unit and the heparin infusion was recommenced at 1000units/hr. The patient had made a significant recovery after the knee washout and was transferred to general medical ward with a plan to cease the heparin infusion in 24hrs. The nurse on the ward had used a pre-mixed heparin infusion supplied at 25,000units/50ml and continued the dose at 5ml/hr. The patient’s APTT next morning was three times the previous value and was noticed to be bleeding from the surgical site on the knee. Integrated Therapeutics Case Study
Q4. Identify the possible reasons behind the bleed and any potential strategies to improve medication safety in that context of the case. Describe 4 common areas where medication errors commonly occur and discuss strategies to improve medication safety. (350 words) (25 marks).