Patient Chart
Mrs. A.B
74 yrs • Female • 68 kg • 160 cm
Diagnosis
Atrial fibrillation, urinary tract infection (new)
Past Medical History
- Atrial fibrillation (5 years)
- Hypertension
- Osteoarthritis
Current Medications
- Warfarin 5 mg once daily
- Bisoprolol 5 mg once daily
- Amlodipine 5 mg once daily
New Prescription
Ciprofloxacin 500 mg — Oral, Twice daily for 7 days
Vitals
BP138/82 mmHgElevatedBlood PressureReference90–120 / 60–80 mmHgActual138/82 mmHg
HR76 bpmNormalHeart RateReference60–100 bpmActual76 bpm
RR16/minNormalRespiratory RateReference12–20 breaths/minActual16/min
TEMP37.8°CElevatedTemperatureReference36.1–37.2°CActual37.8°C
SPO297%NormalOxygen SaturationReference≥ 95%Actual97%
Labs
Serum Creatinine1.3 mg/dLNormalSerum CreatinineReference0.5–1.3 mg/dLActual1.3 mg/dL
Creatinine Clearance42 mL/minModerateCreatinine ClearanceReference≥ 50 mL/min (normal/mild impairment)Actual42 mL/min
eGFR45 mL/min/1.73m²ModerateeGFRReference≥ 60 mL/min/1.73m²Actual45 mL/min/1.73m²
Liver FunctionWithin normal limitsNormalLiver FunctionReferenceWithin normal limitsActualWithin normal limits
Blood Glucose5.6 mmol/LNormalBlood GlucoseReference4.0–7.8 mmol/LActual5.6 mmol/L
INR2.4 (baseline, therapeutic)NormalINRReference2.0–3.0 (therapeutic range on warfarin)Actual2.4 (baseline, therapeutic)
Allergies & Status
No known drug allergies (NKDA)
Not applicable
Clinical Notes
Patient presents with dysuria and urgency. Urinalysis positive for nitrites and leukocytes. Started empirically on ciprofloxacin by the covering physician before pharmacy review.
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What would you do?
Discuss as a group before revealing the AI analysis.