For this Assignment, you evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.
Symptoms of various gastrointestinal (GI) and hepatobiliary disorders often overlap, making diagnosis and treatment challenging. For example, symptoms such as nausea, vomiting, constipation, and diarrhea are non-specific and could also be the result of underlying medical history or current prescription drug use. As an advanced practice nurse, you could be potentially responsible for providing care to a patient who may present with non-specific symptoms related to the gastrointestinal and hepatobiliary systems.
When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (ie diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.
ASSIGNMENT
Submit your Assignment by Day 7 of Week 4 (Sunday night, 11:59 pm ET)
Case studies are a useful way for you to apply your knowledge of pharmacokinetics and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.
For your week 4 assignment, evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.
To Prepare:
Review assignment rubric and case studies. Be sure to thoroughly answer ALL
Explain the problem and discuss how you would address the problem.
When recommending medications, write out a complete prescription for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, special instructions, # dispensed (days supply), refills, etc. Also state if you would continue, discontinue or taper the patient’s current medications.
Answer questions using your required learning resources, clinical practice guidelines, Medscape and JNC 8.
Include at least three references to support each scenario and cite them in APA format. Please include in-text citations. You do not need an introduction or conclusion paragraph.
SCENARIO 1
Donald is a 60 year old male presenting with dyspnea (shortness of breath), chronic productive cough, wheezing, and fatigue. He smokes 1 pack of cigarettes per day for the last 40 years. Post-bronchodilator FEV1/FVC ratio < 0.70 confirms persistent airflow limitation. What treatment plan would you implement for this patient? What medication(s) would you prescribe? How would you monitor the effectiveness of this plan?
SCENARIO 2
Allen is a 49 year-year-old man seeking evaluation for “a burning sensation in my chest,” often after eating and worse at night. He has frequent feelings of bloating and occasional nausea. Allen consumes a diet high in fatty foods and caffeine. He drinks alcohol socially on weekends. PMH includes asthma, diabetes and hypertension. His current medications include prn albuterol, metformin 1000 mg po BID, nifedipine ER 60 mg po daily. How would you improve his drug therapy plan? What changes would you make? What is your working diagnosis and what medication would you prescribe? What information would you provide to the patient at his visit?
SCENARIO 3
Jessica is a 37-year-old female diagnosed with mild persistent asthma. During her visit today, she reports having to use her albuterol 4 days per week over the past month. Over the past week she has been using albuterol at least once per day. She reports being awakened by a cough five nights during the last month. Her current medications include: fluticasone HFA 44 mcg, two puffs BID, albuterol MDI two puffs Q 4–6 H PRN shortness of breath, Medrol Dosepak, metformin 500 mg PO BID, Inderal LA 160 mg po daily. How would you step up therapy for this patient? What medication changes would you make? How would you monitor the effectiveness of this plan? What patient teaching would you provide?
SCENARIO 4
June is a 71-year-old female and has Alzheimer’s Disease x 2 years. She presents with daytime dizziness, fatigue and increasing forgetfulness. Consider her labs and provide an updated drug therapy plan. Include complete medication orders. How would you monitor drug therapy? Labs: TSH 5 mU/L, vitamin D 29 ng/mL, B12 350 pg/mL, Hb 12.1 g/dL, HgA1C = 5.5% Meds: donepezil 5mg po qhs, zolpidem 10mg po qhs
Review the information provided and answer questions posed in the case study
When recommending a medication, write out a complete prescription for the medication
Whenever possible, use clinical practice guidelines in developing your answers when possible
Include at least three references to support your answer and cite them in APA format.