To Prepare:
Review the case study posted in “Announcements” by your Instructor for this Assignment
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.
This week we will apply pharmacology concepts to musculoskeletal system disorders. We will cover the topics of NSAIDs, DMARDs, opioids, and muscles relaxants in relation to the treatment of arthritis, RA, gout, and addiction.
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 (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.
ASSIGNMENT
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 this week’s assignment, evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.
If you are writing a prescription for the scenario, it must be outside the bottom of your paper, below the main body and before the references for that scenario. The Rx must include
Drug and dosage
Directions
Quantity
Refills
MD name
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
What are the errors in the following prescriptions (5 total)? Rewrite each prescription correctly. What is each medication used for? What is the MOA?
· bupropion XL 150 mg po TID #90 3 RF
· lithium carbonate 300 mg po TID #90 for goal therapeutic range of 1.5-2.2 mEq/L
· pregabalin 75 mg po BID #60 6 RF
· atomoxine 40 mg po once daily #30 2 RF
· allopurinol 300 mg PO QID #120 0 RF
SCENARIO 2
Patient TR presents to the clinic needing refills. How would you improve his medication therapy? What patient monitoring would you provide? What are 5 possible disease states TR may have? List them. He is currently on metformin 1000 mg po BID with meals, Synjardy 5 mg/500 mg po BID, Humira 40 mg SC every other week, tizanidine 2 mg po prn muscle pain up to 3 times daily, zolpidem 10 mg po qhs, prednisone 40 mg po daily, atorvastatin 20 mg po daily. Blood pressure is 118/78 and labs include: BG 94 mg/dL A1c 5% sCr 0.9 mg/dL eGFR 101 mL/min/1.73 m² total cholesterol 181 mg/dL LDL 95 mg/dL HDL 57 mg/dL TG 146 mg/dL
SCENARIO 3
PJ is a 35-year-old male with chief complaint “I want to stop drinking but I don’t know how.” PJ reports drinking heavily for the past 10 years. He consumes approximately 8-10 standard drinks per day, primarily beer and occasionally spirits. He has tried to quit drinking multiple times but experiences severe withdrawal symptoms, including tremors, sweating, anxiety, and insomnia, which lead to relapse. PJ denies illicit drug and nicotine use. He is motivated to quit drinking after an episode of blacking out at work. BP 130/78 HR 92. He appears anxious, mild tremor noted with mild abdominal tenderness in the epigastric region, no hepatomegaly. Labs include Hgb 14.2, AST 180, ALT 80, albumin 3.3, bilirubin 1.8, Na 137, K 3.9, Mg 1.7, vitamin B12 310, folate 5, A1C 5.5%
Name 3 medications that can be used to treat Alcohol Use Disorder (AUD). Discuss each medication and select the BEST option. Write complete medication orders for ALL THREE medications. Include patient monitoring and education. Does the patient need to stop drinking when starting the medication?
SCENARIO 4
ER is a 5’6” female that is 35 years old and weighs 155 lbs. She presents with the complaint, “I’ve been feeling really down and tired for months. I can’t concentrate at work, and I just don’t enjoy anything anymore.” She has hypothyroidism x 3 years and is currently on levothyroxine 50 mcg daily. Blood pressure is 115/75 and labs include BG 99 mg/dL, A1c 5%, B12 415 pg/mL, vitamin D 60 ng/mL, TSH 2.8 mIU/L. What would you prescribe for this patient? Include a complete medication order. What additional information would assist your medication selection for ER? What patient education would you provide?
SCENARIO 4
ER is a 5’6” female that is 35 years old and weighs 155 lbs. She presents with the complaint, “I’ve been feeling really down and tired for months.