Pharm w7 assignment

Essay Instructions:

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 within the last 5 years per scenario to support your answer and cite them in APA format. SCENARIO 1 Mary is a 35-year-old woman that has been diagnosed with hypothyroidism. Her labs today show a TSH of 20, MCV 78, MCHD 26, Ferritin 9, TIBC 418. She has a history of iron deficiency anemia for 2 months. Current medications include Kelp tablets daily, ibuprofen 400 mg daily as needed, and ethinyl estradiol/norgestrel one tablet daily.What medication would you start this patient on for her hypothyroidism? How would you monitor this patient’s response to the medication? What education would you provide regarding her medications and their interactions? SCENARIO 2 Joe is a 48-year-old male diagnosed with Type II Diabetes Mellitus for a year ago. He has controlled his blood glucose through dietary changes. He has hypertension and is currently on Lisinopril 20 mg po daily. He has no known allergies. His lab work includes these results: fasting BG is 225 mg/dL; HgA1C = 7.5%. Basic Metabolic Profile (BMP) is normal except for a Cr of 2.0 and eGRF of 28. What treatment plan would you implement for Joe? What medications would you prescribe and how would you monitor them? What education would you provide regarding his treatment plan? SCENARIO 3 Jose is a 55-year-old truck driver being evaluated for his commercial driver’s license. He has a known history of diabetes mellitus type II. Current medications include Metformin 1000 mg Bid, Glipizide 20 mg po daily. Diltiazem 120 mg po BID. He is allergic to sulfa. Lab results show a fasting blood glucose of 325 mg/dL, HgA1C = 10.6%. Basic metabolic Profile is normal. What treatment plan would you implement for Jose? What medications would you prescribe and how would you monitor them? What education would you provide regarding his treatment plan? 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?

Essay Sample Content Preview:

Pharm W7 Assignment Student’s Name Professor’s Name Institutional Affiliations Course Name and Number Due Date Pharm W7 Assignment Mary’s Case The objective test indicating a TSH level of 20 mlU/l, which is beyond the recommended range, confirms hypothyroidism. According to Caron et al. (2022), Levothyroxine (LT4) represents the hormone replacement therapy recommended by the American Thyroid Association guidelines for newly diagnosed patients. The author recognizes the effectiveness of a 1.5 – 1.7 µg/kg/day per os dose in reinstating the euthyroid state. Considering Mary’s BMI, lean body mass, and total body weight will be critical in determining the best estimate for the dose. Biochemical tests are the leading monitoring process for patients taking LT4. Duntas and Jonklaas (2019) indicate that the medication has a half-life of one week, requiring serum TSH reassessment after the 6th week. Such a consideration ensures that the patient reaches a steady pharmacokinetic state. If May’s TSH levels do not meet the desired range, alterations in her treatment dose upwards, such as 119 µg to 130 µg. Follow-up tests after achieving euthyroid state will confirm her status after 3-6 months and annually. Adhering to these guidelines is critical in assisting Mary throughout her recovery. Educating Mary about drug-drug interactions and maximizing their absorption and effectiveness will boost her health outcomes. In this context, Liu et al. (2023) recommend taking levothyroxine before meals, edibles, or drugs to increase absorption. Caron et al. (2022) suggest 30 minutes before breakfast. The patient should also continue taking other anemia medications as prescribed. Moreover, she should comply with the regular monitoring schedule to determine her response to the medicines and achievement improvements. Joe’s Case The laboratory tests of blood sugar at 225 mg/dL confirm that Joe’s diabetes is uncontrolled, leading to the worsening kidney function highlighted by a worrying eGFR rate of 28. As a result, de Boer et al. (2022) indicate that adopting a comprehensive plan would be the best option for such a patient. The plan integrates weight management through exercise, optimized nutrition, pharmacological modalities, and other techniques to control blood pressure, organ functions, and blood sugar. Thus, as a healthcare provider, devising such an approach for Joe increases the likelihood of improving his health outcomes. Joe requires pharmacological intervention to complement his dietary efforts and current Lisinopril for hypertension. The first medication would be an SGLT2 inhibitor, such as canagliflozin, with a maximum dose of 100 mg daily. de Boer et al. (2022) recommend continuing this dose for diabetic patients with an eGFR < 30 mL/min. Monitoring requires achieving a systolic blood pressure (SBP) <120 mmHg in a patient such as Joe (de Boer et al., 2022). Referring Joe to a nephrologist is also critical, as KIDIGO guidelines require in patients with eGFR less than 30 30 mL/min for kidney transplant and replacement therapy evaluation (Chen et al., 2019). Such considerations are critical due to his sensitive status. Educating Joe on self-management and monitoring will be critical for his care. In this context, the focus would be on drug intake compliance to maintain gradual improvement of biochemical indicators such as BG and HgA1C (Clemens et al., 2021). Joes should also recognize the impact of maintaining a healthy lifestyle, inclu...

Updated on September 1, 2024

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