SCENARIO 1
What are the errors in the following prescriptions (5 total)? Rewrite each prescription correctly. What is each medication classification? What is the mechanism of action (MOA)?
- Lupron 3.75 mg Inject SC monthly for endometriosis up to 6 months #1 5RF
- finasteride 1 mg PO daily for BPH #30 3RF (Note: women should not handle crushed/broken tablets- teratogenic to male fetus)
- erythromycin 0.5% otic ointment Apply a ½ inch ribbon to the affected eye(s) every 4 hours x 5 days #1 tube (3.5g) 0RF
- Augmentin (875 mg clavulanate/125 mg amoxicillin) PO every 12 hours x 10 days #20 0RF
- rivoraxaban 20 mg PO daily with evening meal #30 0RF
SCENARIO 2
JL is a 65-year-old female seen in the clinic today. She presents with fatigue, brain fog, sore throat and temperature of 99.1. She reports that symptoms began three days ago with a sore throat and have progressively worsened. She also mentions loss of appetite. Oxygen sat 97%, respiratory rate 17, bp 122/73. Her rapid COVID-19 antigen test is positive. Chest x-ray is clear, no signs of pneumonia. Current medication includes atorvastatin 40 mg po daily. What treatment plan would you implement for JL (include complete medication order)? What patient education and monitoring would you provide?
SCENARIO 3
JS is a 23-year-old woman that presents with fatigue, poor concentration and heavy menstrual periods. Her labs today show TSH 20, MCV 76, MCHC 27, ferritin 11, TIBC 421, Hgb 11.8. Current medications include sumatriptan prn for migraine with aura and drospirenone 4mg one tablet po daily prescribed by her pharmacist, as well as kelp, chromium picolinate, turmeric and green tea supplements daily. What treatment plan would you implement for JS? What medication changes would you make? Include complete medication order(s). How would you monitor the effectiveness of this plan, and what patient education would you provide?
SCENARIO 4
A patient is prescribed gentamicin 5 mg/kg IV once dailyfor a 60 kg patient. The pharmacy stocks gentamicin in 80 mg/2 mL vials.
- How much gentamicin (mg) should be administered per dose?
- How many milliliters of gentamicin solution should be drawn up for each dose?
- If the infusion rate is 10 mg/min, how long will it take to administer one dose?
- A trough level is drawn 30 minutes before the next dose, and the result is 3 mcg/mL. Is the current dosing regimen appropriate based on the trough level? Would you increase, decrease, or leave the dose the same? Please include a complete medication order. What are risks associated with aminoglycoside therapy?
- Why is gentamicin typically administered intravenously rather than orally? How does this relate to bioavailability?