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KENT STONEKING, PHARM.D., CDE, is Director of Clinical Services, Peoples Custom Rx & Clinical Care Center, 785 Brookhaven Circle, Memphis, TN 38117 (kstoneking{at}peoplescustomrx.com).

Papers in the Grand Rounds section are patient case reports and literature review combined in a way that gives them high educational value. The papers lead off with a well-documented case report of an unusual drug experience (e.g., adverse drug reaction, some other unexpected drug response, experimental use of a drug). The case generally deals with a difficult therapeutic problem or dilemma that is commonly encountered but may be overlooked or misunderstood. (Esoteric or rare occurrences of minor importance do not make good Grand Rounds material.) A literature review puts the case in perspective with previously reported similar cases and alternative treatments. The review is integrated with related discussions of the new case being reported. Readers are encouraged to use Grand Rounds for educational group discussions. For this purpose, discussion questions are printed at the end of the Grand Rounds papers.