[Part 1] Inquiry Problem <Emergency Department: Traffic Trauma Edition>

For pharmacists, making inquiries is very nerve-wracking. It might be the biggest hurdle, especially for newcomers or students in training.
In particular, I think many don't even know what kind of things pharmacists make inquiries about.
I have created some problems to help you get used to such issues.
I will update them as frequently as possible, so please take a look, pharmacy students, pharmacists, and other healthcare professionals! 😊

Now, for the first part.

Question 1

Emergency Department, 20-year-old male, height 160 cm, weight 60 kg
Lab values: WBC: 8000, GOT: 20, GPT: 20, BUN: 18, sCre: 0.72, CRP: 3.2

History of present illness
Today, while walking down the stairs in the afternoon, he missed a step and fell. He had severe pain in his left foot at the time of the fall and went to the emergency room. As a result of the diagnosis, it was a sprain and contusion, and since there was no damage to the head or other areas, he was sent home with painkillers.

Prescription
Rp1. Loxoprofen tablets 60mg, 3 tablets, 3 times a day, after each meal, for 3 days
Rp2. Rebamipide tablets 100mg, 3 tablets, 3 times a day, after each meal, for 3 days
Rp3. Acetaminophen tablets 500mg, 2 tablets per dose, when in pain, for 10 doses
Can be taken with a 4-hour interval

Now, what would you do for an inquiry in this case?

The hint is that there is a set upper limit for the dosage of pharmaceuticals. Exceeding that limit makes side effects more likely. Let's think about the upper limit of medication.

Prescription
Rp1. Loxoprofen tablets 60mg, 3 tablets, 3 times a day, after each meal, for 3 days
Rp2. Rebamipide tablets 100mg, 3 tablets, 3 times a day, after each meal, for 3 days
Rp3. Acetaminophen tablets 500mg, 2 tablets per dose, when in pain, for 10 doses
Can be taken with a 4-hour interval

The answer is here.
Since this is a famous story, I'm sure many of you caught on, right?

Acetaminophen is a representative antipyretic analgesic. It is a relatively safe drug, but it is also famous for causingliver dysfunction.
And the upper limit for acetaminophen dosage isup to 4000mg.
If this patient were to take 1000mg per dose every 4 hours, they could take up to 6000mg in a day.

When making an inquiry, options such as1) reduce the single dose, 2)set the dosing interval to 6 hours, 3)limit it to 4 times a day
can be considered. I don't think any of these are wrong. Ultimately, it is the doctor's decision.

During hospitalization, it is common to exceed the dosage limit when combined with intravenous acetaminophen, or when combined with drugs that contain acetaminophen, such as combination drugs like Ultracet, so be careful.

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