Pharmacokinetics and pharmacodynamic aspects
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 assignment, 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 studies (see below) and answer ALL questions.
• 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.
• Use clinical practice guidelines in developing your answers. Please review all Required Learning Resources. Use the Medscape app or website to complete assignment.
• 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 4
Jenny is a 63-year-old woman with complaints of heartburn 4 to 5 times a week over the past 3 months. Her symptoms are worse at night after going to bed. Her heartburn is worse, and she coughs a lot at night. She has tried OTC Prevacid 24 hour once daily for the past 2 weeks. This has helped the symptoms some, but she is still bothered by them. Current medications include Diltiazem CD 120 mg PO once daily, Hydrochlorothiazide 25 mg PO once daily, Metformin 500 mg PO twice daily, Aspirin 81 mg PO daily, Fluticasone/salmeterol DPI 100 mcg/50 mcg one inhalation twice daily. Your working diagnosis for this patient is GERD. What treatment plan would you implement for Jenny? What medications would you prescribe and how would you monitor them? What education would you provide regarding her treatment plan?
Based on Jenny\’s symptoms and working diagnosis of GERD (Gastroesophageal Reflux Disease), here\’s a treatment plan, including medications, monitoring, and education:
Medications:
1. Proton Pump Inhibitor (PPI): Since Jenny has tried OTC Prevacid (a PPI) with some relief but not complete resolution, switching to a stronger PPI or increasing the dose might be necessary. I would prescribe:
– Esomeprazole (Nexium) 40 mg PO once daily: This is a stronger PPI compared to Prevacid.
2. Antacid: To provide immediate relief from heartburn, an antacid can be added:
– Calcium carbonate (Tums) 1000 mg PO as needed for breakthrough symptoms: She can take this between doses of the PPI if needed.
3. H2 Blocker (Optional): If PPI alone is not sufficient, an H2 blocker can be added for additional acid suppression:
– Famotidine (Pepcid) 20 mg PO twice daily
Monitoring:
1. Symptoms: Jenny should keep track of her symptoms, noting the frequency and severity of heartburn and nighttime coughing.
2. Side Effects: Monitor for any adverse effects of the medications, especially with the addition of a stronger PPI.
Education:
1. Medication Regimen: Explain the purpose of each medication, including how PPIs work to reduce stomach acid and antacids for immediate relief.
2. Dosage and Timing: Ensure Jenny understands the correct dosage and timing for each medication, emphasizing consistency.
3. Lifestyle Modifications: Encourage Jenny to make lifestyle changes to alleviate GERD symptoms, such as:
– Elevating the head of her bed to reduce nighttime reflux.
– Avoiding large meals, especially before bedtime.
– Identifying and avoiding trigger foods and beverages (e.g., spicy foods, caffeine, alcohol).
– Losing weight if overweight or obese.
– Quitting smoking if applicable.
4. Long-Term Management: Emphasize the importance of long-term management and adherence to the treatment plan, as GERD is a chronic condition that requires ongoing care.
5. Follow-Up: Schedule a follow-up appointment to assess the effectiveness of the treatment plan and make adjustments if necessary.
By implementing this comprehensive treatment plan, monitoring Jenny\’s symptoms, and providing thorough education, we aim to improve her GERD symptoms and overall quality of life.
Paper Format: APA
Number of pages: 2
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