Minor ailment service for patients treated with narrow therapeutic index drugs

We report two clinical cases assessed in our minor ailment service presenting with symptoms suggestive of common digestive disorders. Both patients were treated with narrow therapeutic index drugs (lithium carbonate and digoxin, respectively). In both cases, medication analysis revealed that referred symptoms might be elicited by these drugs: abdominal discomfort is a frequent adverse reaction in long term treatments with lithium carbonate while in the case of digoxin symptomatology was found to be accompanied by bradycardia. Thus, we propose two different pharmaceutical interventions, one being an urgent general practitioner referral. Pharmacotherapy assessment during minor ailment service, focused on narrow therapeutic index drugs, is a key point in discriminating minor ailments from potential life-threatening situations.