Case Study Special Considerations
Utilize the case study below for a patient population for special consideration during prescribing practices. Consider the specific patient and determine the appropriate medication to prescribe, based on the patient specifics and medication attributes in various case studies. Construct a 4- to 5-page paper in which you determine the medication, the dosing, necessary patient education, and potential side effects. You will also indicate why the other medications would not be appropriate, as well as any necessary labs or diagnostics that might be needed. You will develop a plan to enhance medication adherence for the nonadherent patient.
In the paper include the following:
• Determine which medication would be most appropriate to prescribe from the assigned vulnerable population patient case medication choices.
• Explain your rationale for choosing this medication. Explain why the other medications listed are not appropriate for this patient.
• Explain the dosing schedule for the specific patient including the therapeutic endpoint.
• Provide necessary education to the patient to review risks, benefits, and potential side effects of the medication.
• Describe any necessary labs or additional diagnostics needed prior to prescribing this medication.
• Explain how you might monitor efficacy or side effects of the medication.
• Include any additional collaboration or education to others that would be necessary for this patient. Consider family members, home health care, primary care providers, etc.
• What would you need to include in your assessment for a patient who may become nonadherent with your prescribing plan for your scenario? What are alternative treatment solutions based upon how you assessed? Describe your new treatment plan.
This Assignment requires a minimum of five (5) peer-reviewed, evidence-based scholarly references outside of course resources.
Include the APA style formatting.
Patient 2: 76-year-old female who recently moved from her home to an assisted living. After 1 week of moving in, she has become extremely confused. Staff have attempted to re-orient her, and she struggles to focus on what they are saying. She is only oriented to self. She has become very agitated and has even thrown breakable objects in her room. Her family is concerned stating she is “out of it.” The PCP ordered labs and UA. Labs are unremarkable outside of mild leukocytosis and positive dipstick analysis for nitrite and red blood cells. Med List: valproate, alprazolam, trimethoprim
Case Study Special Considerations
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Case Study Special Considerations
Appropriate Medication
The course of action that is most relevant for prescription, in this case, is to provide the patient with antibiotics since there is a UTI, according to the dipstick findings that show the presence of nitrite and red blood cells in the urine. Antibiotics are often used for treating UTIs and are appropriate to use when managing older people who have specific medical issues that increase vulnerability to developing infections due to physiological changes associated with aging (González et al., 2024). Leukocytosis is also evident from the patient's laboratory data, which suggests an infection; therefore, using antibiotics is most appropriate in this case. Depending on the current medications used by the patient, which include valproate and alprazolam, the PCP has to ensure that he selects an antibiotic that will not be averse to them (Rodríguez et al., 2024). An example of a sulfonamide antibiotic to be used since it has no interaction with valproate or alprazolam is trimethoprim.
The Rationale for Choosing This Medication
The necessity of choosing an antibiotic as a type of treatment and selecting a particular antibiotic, in this case, are several points that can explain trimethoprim. Firstly, the patient's signs and symptoms suggest a urinary tract infection, a frequent experience in the elderly because of the anatomical changes that happen to the bladder and the urinary tract with aging. Hence, proper medication must be given to the patient to treat the infection that led to the formation of these clots and to avoid any other faulty developments. Secondly, antibiotics are relatively safe and have high efficacy for UTIs and are, therefore, used for managing the condition in the elderly population (González et al., 2024). The rest of the medications that are mentioned – valproate and alprazolam – do not correspond to the patient's condition at the moment. Valproate is prescribed for epilepsy and bipolar disorder; therefore, the patient cannot develop a sudden change in mental status due to the intake of the drug. Moreover, valproate is not reported to result in confusion or agitation as some of its side effects. Alprazolam is a benzodiazepine that is tried for anxiety and can worsen situations by causing sedation in elderly patients, but currently, their complaint is not related to alprazolam.
The Dosing Schedule
The dosing intervals of the given trimethoprim depend on the formulation and severity of the particular UTI in a patient. In cases where the patient cannot take tablets orally, a liquid formulation of the medicine exists. As for trimethoprim, usually, it is prescribed at 100mg twice daily for 3-7 days. For moderately severe infections, the dose is usually 200 milligrams in the morning and the evening, so 400 milligrams a day for seven to fourteen days (Roberti et al., 2020). The patient should, however, complete the prescribed course of antibiotics to eliminate the infection and reduce the chances of the bacteria developing resistance to the antibiotics. The valuable and realistic therapeutic goal for the woman is the reduction of the provided diagnosis-associated signs and symptoms, including severe urinary tract pain, burning during urination, and the patient's confusion, and increased agitation. The treatment efficiency will be concluded with the follow-up urinalysis and the improvement of the symptoms. The patient's health status may also be assessed for any side effect of the antibiotic, for instance, gastrointestinal discomfort or skin rash in which the dose can be altered (Silva et al., 2021). Treatment a