Nitrofurantoin (NIT) is a commonly utilized antibiotic for the treatment of UTIs. Although well tolerated, NIT is not without potential adverse reactions. This case report details the observation of probable NIT-induced drug fever in a patient receiving clozapine. A 61-year-old female with treatment-refractory schizoaffective disorder was admitted to a psychiatric unit with paranoia and auditory hallucinations, prompting clozapine initiation during day 1 of hospitalization. Due to worsening hallucinations and anxiety, antibiotic therapy with NIT for a presumed UTI was initiated 8 days after admission. Febrile episodes were observed beginning on hospital day (HD) 9, leading to concern for possible neuroleptic malignant syndrome (NMS), which led to clozapine discontinuation. The patient received a total of 3 doses of NIT with continued fever until discontinuation on HD 10. No further complications were encountered, and clozapine was safely resumed on HD 13. Although sparsely described in the medical literature, occurrences of drug fever attributable to NIT are previously reported. A review of the medical literature identified only 5 previously published articles specific to NIT-induced drug fever, none of which specified interruptions of psychotropic therapy for a patient with acute psychiatric decompensation. This case highlights the differential diagnosis of fever related to NIT in a patient receiving clozapine when NMS was initially suspected.
Introduction: Student wellbeing is a key component of pharmacy programmes, with most events occurring in-person through co-curricular or extra-curricular activities. With the shift to online classes due to COVID-19, many wellness events were cancelled due to social distancing limitations. However, promotion of wellbeing was considered to be of utmost importance during this time due to rising levels of stress and social isolation among students. Description: The school’s Instagram and Facebook accounts were managed by a group of the university’s faculty for six weeks. Each week, different daily wellness themes were shared and participation by followers encouraged through quizzes, polls, or reposts. The Instagram stories and posting platforms were used routinely with select posts also shared via Facebook. A new hashtag was created and promoted to encourage additional posting and community building. Video stories were also shared of faculty expressing their mental/physical health challenges and subsequent coping mechanisms during COVID-19. Results: During the last six weeks of virtual learning, 280 stories and 23 posts were shared via Instagram. Shared stories included promotion of: cardiovascular exercise, weight training, yoga, music, media, gratitude, recognition, positive thinking, coping and games. Overall, 20 different faculty and staff were involved in sharing video stories to promote wellbeing. Of the 13 posts also shared to Facebook, a total of 10,429 people were reached. Conclusion: School social media platforms can be used to regularly connect virtually during times of crises. Promoting wellness activities can help engage students and faculty/staff to ensure they are focusing on their own wellbeing. With social distance regulations for the foreseeable future, pharmacy programs should consider using social media as a wellbeing tool for both student and faculty/staff engagement
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