Overview
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 Assignment, you evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.
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.
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.
- 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)? · linaglipton 5 mg PO daily #30 5 RF · Tresiba inject 10 units SC TID with meals #1 box of 5 pens 1 RF · tiotropium (Spiriva) 2.5 mcg PO BID #60 1 RF · Qulipta 60 mg PRN for migraine #30 1 RF · levothyroxine 88 mg PO daily #30 5 RF
- SCENARIO 2 PK is a 16-year-old female diagnosed with mild persistent asthma since age 12. During her visit today, she reports having to use her albuterol MDI 3 days per week over the past 2 months. Over the past week she has been using albuterol at least once per day. She reports being awakened by a cough 5 nights during the last month. She also has a fluticasone MDI, which she uses “most days of the week.” Her current medications include: Flovent HFA 44 mcg two puffs BID, Proventil HFA two puffs Q 4-6 hr PRN shortness of breath, fexofenadine 180 mg po daily, diphenhydramine 50 mg qhs prn. What treatment plan would you implement for PK? What medication changes would you make? Include a complete medication order. How would you monitor the effectiveness of this plan, and what patient education would you provide?
- SCENARIO 3 ES is a 45-year-old African American male that was prescribed bisoprolol for his high blood pressure. Blood pressure today is 142/89 HR 60 RR 15. He states that he only occasionally takes the medication because he does not like the side effects. What information would you provide to the patient at his visit? What is his goal blood pressure? How is hypertension treated per current guidelines (JNC 8, ACC, AHA)? How would you improve his treatment? Include a complete medication order.
- SCENARIO 4 TF is a 60 year old male presenting to the clinic for medication refills. Current medications include acetylcholinesterase inhibitor donepezil 5 mg po qhs, anti-amyloid monoclonal antibody lecanemab (Leqembi) 10 mg/kg IV every 2 weeks for early Alzheimer’s disease, and atorvastatin 40 mg po daily. His lab work today includes: fasting BG is 195 mg/dL; HgA1C = 8.5%. Basic Metabolic Profile (BMP) is normal except for Cr 1.9 and eGRF 28. What is his goal A1C? Please SELECT and DISCUSS which of the following would be best to prescribe for TF: · canagliflozin (Invokana) 100 mg PO daily · exenatide (Byetta) 5 mcg SC twice daily · glimepiride 1 mg PO daily · glyburide 2.5 mg PO daily · metformin 500 mg PO daily · semaglutide (Ozempic) 0.25 mg SC once weekly · sitagliptin (Januvia) 50 mg PO daily
Note: If you do not purchase Lecturio, please consult these resources for this week.
- Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Elsevier.
- Chapter 64, “Drugs for Peptic Ulcer Disease” (pp. 589a–597)
- Chapter 65, “Laxatives” (pp. 598–604)
- Chapter 66, “Other Gastrointestinal Drugs” (pp. 605–616)
- Chapter 68, “Drugs for Weight Loss” (pp. 627–637)