CASE 1 M.A. is a 53 yrs old man.

A year ago, he started to complain of disturbances in mood ranging from episodes of euphoria and happiness to episodes of severe depression. He was diagnosed to have manic-depressive disorder. Since then he has been on lithium tab. daily. He has HTN and is treated with spironolactone tab. 3 months ago& with the start of winter, he started to complain from his recurrent attacks of dyspnea, bronchoconstriction & productive cough. He was diagnosed to have severe allergic bronchitis. He was prescribed Theo 300 mg daily, hydrocortisone, Ampicillin 500 mg cap q 8 hrs. 2 weeks ago he began to complain of polyuria, polydipsia & a feeling of thirst. Lately he started complaining of pain in his joints. He was asked for analysis of uric acid, blood glucose & serum electrolytes. Lab. Results: Uric acid9.2 mg/dl [3.5-7.2 mg/dl]

Sodium169 mEq/l [135-145 mEq/l] Bl.glucose145 mg/dl [65-110 mg/dl] Potassium4.5 mEq/ [3.8-5.5 mEq/l] After his analysis he was prescribed Allopurinol and Chlorpropamide. Questions: 1. What does M.A. have? 2. Is there any drug interactions? 3. What is your recommendations concerning his medications? 4. Do you suggest any other solution for his recently discovered problem?