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Plan for safety: Monitoring a patient for medication toxicity

Type of activity: Text case

Activity summary

This text case describes a patient who suffers medication-related toxicity. The facilitation questions and suggestions to faculty focus on helping learners to identify medication risk factors for patients and to consider strategies for minimizing such risks.

Case scenario

A 72-year-old woman with a history of bipolar disorder and hypothyroidism is treated with lithium and thyroxine. The patient is subsequently diagnosed with hypertension and her family physician is considering initiating a diuretic. The physician is aware of the potential for interaction between lithium and diuretics.

Facilitation questions

  1. What should the physician discuss with the patient about the proposed treatment plan?
  2. How should the physician document the decision to treat/not to treat?
  3. What would you include in the discharge instructions?
  4. What would you include about the therapeutic plan in the clinical documentation?

Suggestions to faculty

Ask learners to identify the 3 elements of informed consent and to describe the key information that should be documented following a consent discussion. Also discuss key information that should be included in discharge instructions such as (but not limited to) required follow-up, read-back, safety netting, and red flags for patient self-monitoring.

Additional resources

CanMEDS: Medical Expert, Communicator, Professional

DISCLAIMER: The information contained in this learning material is for general educational purposes only and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. The use of CMPA learning resources is subject to the foregoing as well as the CMPA's Terms of Use.