Elevated serum transaminase levels resulting from concomitant use of rosuvastatin and amiodarone.

PURPOSE: The case of a patient whose serum transaminase levels became elevated after concomitant use of rosuvastatin and amiodarone is described. SUMMARY: A 73-year-old white woman with a medical history of diabetes mellitus, hypertension, hypothyroidism, hyperlipidemia, and aortic stenosis reported to a clinic on February 9, 2006. Laboratory tests revealed the following values: total cholesterol, 172 mg/dL; low-density-lipoprotein cholesterol, 96 mg/dL; high-density-lipoprotein cholesterol, 55 mg/dL; triglycerides, 105 mg/dL; aspartate transaminase (AST), 14 IU/L; alanine transaminase (ALT), 13 IU/L; alkaline phosphatase (ALP), 68 IU/L; and serum creatinine (SCr), 1.1 mg/dL. At this time, rosuvastatin 5 mg daily was initiated. On April 20, 2006, laboratory tests revealed an AST of 30 IU/L, ALT of 58 IU/L, ALP of 99 IU/L, and SCr of 1.0 mg/dL. Because of the severity of her aortic stenosis, the patient underwent aortic valve replacement on May 15, 2006, and amiodarone was initiated. Laboratory tests completed on May 31, 2006, revealed an AST of 192 IU/L, ALT of 336 IU/L, ALP of 322 IU/L, and SCr of 1.1 mg/dL. She did not report any symptoms of myopathy or liver dysfunction. Ultrasound revealed no liver abnormalities. The rosuvastatin was discontinued because of a potential interaction with the amiodarone. One week after the rosuvastatin was stopped, her laboratory tests showed an AST of 68 IU/L, an ALT of 126 IU/L, an ALP of 292 IU/L, a creatine kinase concentration of 22 IU/L, and an SCr of 1.0 mg/dL. Two months later, her liver function test values had continued to decline. CONCLUSION: A potential interaction between rosuvastatin and amiodarone resulted in asymptomatic elevation of serum transaminase levels in a 73-year-old woman.

Pharmacy students' reading ability and the readability of required reading materials.

OBJECTIVE: To determine the reading level of third-professional year doctor of pharmacy students and whether a significant correlation existed between Nelson-Denny Reading Test (NDRT) grade equivalence scores and the Pharmacy College Admission Test (PCAT) percentile scores, and to determine the reading level of selected course materials. METHODS: The NDRT was administered to third-professional year (P3) pharmacy students. Scores from the NDRT were compared to the percentile rankings of the students' PCAT scores to determine whether significant correlations existed. Chapters from a pharmacy textbook and published medical guidelines were assessed using the Gunning FOG readability formula. RESULTS: Based upon the NDRT, the average reading grade level for pharmacy students was 16.5 years. There was a strong correlation between the vocabulary scores from the NDRT and the PCAT verbal percentile (rho = 0.776, p < 0.001). The average readability grade level of the materials assessed was 18.0 years for the textbook and 19.2 years for the medical guidelines. CONCLUSIONS: The verbal PCAT percentiles strongly correlate with the vocabulary grade equivalence scores on the NDRT. A moderate correlation was found between the composite PCAT percentiles and NDRT total grade equivalence scores. There was also a disparity between the average reading level of the students and that of the reading samples that were assessed.