Pharmacotherapy follow-up of a 49-year-old woman with bipolar affective disorder suffering metabolic syndrome: case report

Abstract

Metabolic Syndrome (MS) has achieved high prevalence in Brazil and the world, being that failures are a common outcome in the clinical and pharmacological managements of patients with MS. A pharmacotherapeutic follow-up (included in the pharmaceutical care) affords a most effective, safe, and suitable therapy, improving the patient’s quality of life. This report covers a case of MS affecting a patient with co-morbidities enrolled at a pharmacotherapeutic unity in Alfenas, MG, Brazil (according to the Dáder methodology). Case report: C. O. F., 49-year-old woman, melanoderm, who had been suffering from Bipolar Affective Disorder (BAD) and type 2 Diabetes Mellitus (DM), Dyslipidemia, Body Mass Index (BMI) = 34.6 Kg/m², and abdominal circumference of 120 cm (Obesity). The patient presented with MS and she complains hyperglycemia (fasting blood glucose levels [FBGL] higher than 300 mg/dL). Thus, a pharmacotherapy follow-up was solicited. As an attention plan, the goals included a reduction in body weight and a control of glycemia, moreover, owing to the patient takes multiple medications (for BAD and type 2 DM), she had the pharmacotherapy evaluated, possible problems detected and interventions performed, including: (1) Health education; (2) The non-pharmacotherapy approach (Counseling); (3) The pharmacotherapy performed (Counseling); (4) Follow-up of glycemia, blood pressure (BP) and  body weight; and (5) Pharmaceutical care intervention (PCI). During three months under pharmacotherapy follow-up, the BP was kept under control and BMI decreased, which allowed to monitor the effectiveness of the therapy and the outcome of the health education performed. In the PCI, measures took interdisciplinary together with an endocrinologist led to the inclusion of regular insulin in the therapeutic arsenal. Consequently, at the end of the follow-up, these actions resulted in the reduction of FBGL from 300 to 179 mg/dL, reducing the complaints caused by the therapeutic failure. Therefore, the pharmacotherapeutic follow-up allowed the health promotion, resolution of problems related to the pharmacotherapy and revision of patient’s therapeutic goals, including improvements toward adherence to the treatment, effectiveness of therapeutic, and absence of adverse drug events and drug interactions.