Cases

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Cases

• Infant formulas and Diaper Rash
• 2/22/05
• Mahshid Roayaee, Pharm.D.

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Case 1

• James is a full term newborn male. His mom does
  not want to breast feed. She is asking what
  formula to choose. He was a healthy infant and
  was 8 pounds at birth.

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Case 1 (Contd)

• Will recommend a milk based formula
• (Either Similac or Enfamil)
• Figure out his Kcal/day and
• his maintenance fluids.

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Case 2

• A mother with her 1 month old and 5 year old
  child presents to your pharmacy. She has been
  feeding her baby with Enfamil with Iron and he
  developed projectile vomiting and watery
  diarrhea. She tells you that baby never had
  anything like this as an infant.

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Case 2 (Contd)

• What is the problem?
• Why is this most likely occurring?
• What formula would you recommend using?

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Case 3

• Grace is a little 1 month old who is very cranky
  and every time she comes to your pharmacy with
  her mom, all the other customers leave because of
  her high pitched cry. Her mom brings her to your
  pharmacy today and ask about any new formula that
  you might have which may help with bloody stools.
  Upon questioning mom, she explains that Grace
  always had bloody stools and is not gaining
  weight properly.

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Case 3 (Contd)

• What is the most likely problem?
• What is your recommendation?
• Is referral to a specialist (Pediatric
  Gastroenterologist) warranted?

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Case 4

• Jake is a colicky baby whose mom is one of your
  frequent flyers for refilling Jakes Zantac
  prescription. When she comes to your pharmacy
  this time to pick up the prescription she also
  has a Enfamil AR canister to ring up.
• What is your first question?

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Case 5

• You are working the midnight Sunday shift at Osco
  drugs. It has been a rainy night and most
  everybody decided to stay home. All of a sudden a
  very upset new dad comes to your store with a
  inconsolable baby. He is explaining to you that
  his baby has had diarrhea for a week and also has
  a very bad diaper rash. His wife went to a
  business trip and he doesnt know what to do with
  the baby and how to take care of the rash.