This week we will apply pharmacology concepts to disorders associated with women and men’s health, such as hormone deficiencies, cancers, and other functional and structural abnormalities. Your Learning Resources also include material on eye, ear, and skin disorders and pharmacologic treatment.
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. Whenever possible, use clinical practice guidelines in developing your answers.
ASSIGNMENT
Case studies are a useful way for you to apply your knowledge of pharmacokinetic and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.
For this assignment, evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.
INSTRUCTIONS
Format
- . LIST REFERENCES AFTER EACH SCENARIO.
SCENARIO 1
What are the errors in the following prescriptions (1 per prescription)? Rewrite each prescription correctly. What is each medication’s classification and mechanism of action (MOA)?
- rivoraxaban 20 mg PO daily with evening meal #30 0RF
- tamsulosin (Proscar) 0.4 mg po daily, 30 minutes after the same meal each day #30 2 RF
- Bactrim DS(sulfamethoxazole/trimethoprim 875/125 mg) po twice daily for 7 days for UTI #14 0RF
- cephalexin (Cefzil) 500 mg po QID x 7 days #28 0 RF
- ciprofloxacin 0.3% otic solution for bacterial conjunctivitis; instill 1-2 drops into eye every 2 hours while awake for 2 days then 1-2 drops every 4 hours while awake for the next 5 days #1 bottle 0 RF
SCENARIO 2
FL is 48-year-old woman presenting with hot flashes related to menopause. Current medical conditions include hypertension and ADHD. She reports that stimulant medications caused significant insomnia and appetite suppression in the past. She is seeking a single medication that may help manage more than one of her conditions.
Which of the following medications would be the most appropriate choice for this patient? WHY? What is the medication’s MOA and what would you monitor?
- estradiol 1 mg PO daily
- progesterone 200 mg PO at bedtime
- venlafaxine XR 75 mg PO daily
- clonidine 0.1 mg PO twice daily
- bupropion XL 150 mg PO daily
SCENARIO 3
TN is a 26-year-old female presenting with thick white, odorless vaginal discharge and itching for 2 days. She is sexually active and has had unprotected sex with a new male partner for the last month. Current medications include fluoxetine 20 mg po daily, valacyclovir 500 mg po daily, zolpidem 10 mg po qHS, Depo-Provera 150 mg IM q3 months. TN reports drinking kava several times a day. She is allergic to sulfa drugs. What medication would you prescribe for TN (include complete medication order)? What is a possible differential diagnosis? How long should she abstain from sexual activity? What patient education would you provide?
SCENARIO 4
GA (70 kg patient) is prescribed vancomycin 15 mg/kg IV every 12 hours. The pharmacy stocks vancomycin 1 g per 20 mL vials.
- How much vancomycin (mg) should be administered per dose?
- How many milliliters of vancomycin 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 4th dose, and the result is 9 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 vancomycin therapy?
- Why is vancomycin usually given IV and not PO? How does this relate to bioavailability?
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