Question - Sepsis and Crohn's disease
Mrs AB is a 70 year old female living at home with her husband. She was admitted to the hospital via the Emergency department with fever and severe abdominal pain, which was later diagnosed as sepsis from an intra-abdominal abscess. Her past medical history includes Crohn’s disease, hypertension and osteoarthritis of knees.
Mrs AB’s regular medications include:
Prednisolone 10 mg po daily tapering dose
(starts at 60 mg daily six months ago for an acute flare up of Crohn’s disease)
Azathoprine 50 mg po daily
Amlodipine 5 mg po daily
Ibuprofen 200 mg QID PRN for knee pain
Hyoscine 10 mg TDS PRN for stomach cramping
a) Suggest a suitable empirical antibiotic regimen for this patient with drug name and dosage regimen. Explain your rationale on choosing such regimen. (3 marks)
b) Apart from the treatment of infection, discuss TWO other crucial components that must be considered as part of the overall management plan of Mrs AB’s sepsis. Include in your discussion some potential therapies that may be given to Mrs AB. (6 marks)
c) Upon reviewing Mrs. AB’s regular medications, identify THREE additional drug related problems from her regimen and make appropriate recommendations accordingly. (6 marks)