Jessica is a 28 year-old married female. She has a very demanding, high stress job as a second year medical resident in a large hospital. Jessica has always been a high achiever. She graduated with top honors in both college and medical school. She has very high standards for herself and can be very self-critical when she fails to meet them. Lately, she has struggled with significant feelings of worthlessness and shame due to her inability to perform as well as she always has in the past. For the past few weeks, Jessica has felt unusually fatigued and found it increasingly difficult to concentrate at work. Her coworkers have noticed that she is often irritable and withdrawn, which is quite different from her typically upbeat and friendly disposition. She has called in sick on several occasions, which is completely unlike her. On those days, she stays in bed all day, watching TV or sleeping. At home, Jessica’s husband has noticed changes as well. She has shown little interest in sex and has had difficulties falling asleep at night. Her insomnia has been keeping him awake as she tosses and turns for an hour or two after they go to bed. He has overheard her having frequent tearful phone conversations with her closest friend, which have him worried. When he tries to get her to open up about what is bothering her, she pushes him away with an abrupt “everything’s fine”. Although she has not ever considered sui-slide, Jessica has found herself increasingly dissatisfied with her life. She has been having frequent thoughts of wishing she were dead. She gets frustrated with herself because she feels like she has every reason to be happy, yet can’t seem to shake the sense of doom and gloom that has been clouding each day as of late.
What is Jessica's diagnosis? Explain your answer.

Jessica's diagnosis will be major depressive disorder. This disorder is also

known as Clinical depression.

Major depressive disorder involves an individual having persistent feeling of

sadness and loss of interest in daily activities which comes with occasional

feeling of death .This could be treated through medication and

therapy.

The symptoms include loss of appetite and sleep and in the case of Jessica

we were told she began to feel worthless and uninterested at work and daily

activities which is why Major depressive disorder is the right choice.

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A patient presents you with three individual prescriptions for Methylphenidate. The first states
that it should not be filled until thirty days from today's date, the second states that it should not
be filled until sixty days from today's date, and the third has no such instruction.
In an event like this, what should you do?
Refuse to fill the prescription and explain that presenting multiple prescription blanks for
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Fill the prescription without date restrictions immediately and contact the prescriber
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If your state allows the issuance of multiple prescriptions, you may dispense all three
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Confer with your Pharmacist to understand if your state allows the issuance of multiple
prescriptions, you may dispense the prescription without date restrictions, and fill the
remainder on the appropriate dates.

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