Short Essays -Summer
1. Discuss at least three symptoms caused by physiologic changes and consequences of hypertension. Discuss how pharmaceutical treatments are designed to alleviate those symptoms. What are the risks and benefits of these treatments? What are potential drug interactions with this these medications? What added therapy would you consider if the patient’s hypertension were complicated by heart failure? What therapies would you avoid? What patient education is needed in terms of compliance and expectations of medications prescribed?
2. Discuss at least three symptoms caused by physiologic changes and consequences of hypothyroidism and hyperthyroidism. Discuss the findings for each type of thyroid disorders; comparing and contrasting symptoms, lab findings, and possible etiologies. Discuss how pharmaceutical treatments are designed to alleviate those symptoms. What are the risks and benefits of these treatments? What are potential drug interactions with these medications?
3. Discuss at least three symptoms caused by physiologic changes and consequences of GERD and peptic ulcer disease (PUD). Discuss the findings for each disorder, comparing and contrasting symptoms, lab findings, and possible etiologies. Discuss how pharmaceutical treatments are designed to alleviate those symptoms. What are the risks and benefits of these treatments? What are potential drug interactions with these medications?
4. Discuss at least three symptoms caused by physiologic changes and consequences of Gout and Osteoarthritis. Discuss the findings for each disorder, comparing and contrasting symptoms, lab findings, and possible etiologies. Discuss how pharmaceutical treatments are designed to alleviate those symptoms. What are the risks and benefits of these treatments? What are potential drug interactions with these medications?
5. What is the impact of a lack of availability or access to needed cancer medication during disasters and emergency management? What can be done to mitigate these concerns? What is the role of the nurse within a multidisciplinary team during times of disaster response for this population?
6. Metabolic syndrome is an increasing issue in the US. What factors contribute to development of the syndrome, who is more at risk for this syndrome, and how does this syndrome intersect for higher rates of obesity and the development of increase risks of heart disease, stroke and type 2 diabetes? What pharmacology intervention and interprofessional input may help control aspects of metabolic syndrome?
Short Essays
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Question 1
Hypertension is a serious condition that can lead to damage to vital body organs such as the heart and the brain (Iqbal & Jamal, 2020). High blood pressure damages the arteries, and the flow of blood and oxygen to the heart becomes limited. Patients can experience angina as a result of limited blood flow, as well as heart attack and heart failure. Also, there can be limited blood flow to the brain due to artery damage, which can cause a stroke (Iqbal & Jamal, 2020). Shortness of breath and blurred vision are also symptoms caused by physiologic changes of hypertension.
Pharmacological treatment involves the use of diuretics, beta-blockers, and angiotensin-converting enzyme inhibitors (Iqbal & Jamal, 2020). Diuretics work by increasing urine output and decreasing blood volume, while beta-blockers reduce cardiac output. Other antihypertensive drugs work by relaxing the smooth and heart muscles to promote blood flow. However, patients using these drugs may experience side effects such as coughing, sexual dysfunction, dizziness, and gastrointestinal issues, among others.
Potential drug interactions include non-steroidal anti-inflammatory drugs (NSAIDs), cardiovascular drugs such as aspirin, and other antihypertensive drugs, such as amlodipine and atenolol (Subramanian et al., 2018). Patients with heart failure should receive diuretics, beta-blockers, and angiotensin-converting enzyme inhibitors as first-line drugs for hypertension. However, alpha-receptor blockers should be avoided. To increase effectiveness, patients must adhere to the treatment plan. Providing patients with drug-related information and how to take them can improve compliance.
Question 2
Hypothyroidism occurs when the thyroid fails to produce and release sufficient thyroid hormones, thus slowing metabolism (Patil et al., 2021). Patients experience symptoms such as weight gain, fatigue, intolerance to cold temperatures, and dry skin/coarse hair. Usually, serum thyroid-stimulating hormone (TSH) levels are checked to determine whether a patient has hypothyroidism. High TSH levels are found in patients with hypothyroidism (Patil et al., 2021). Also, the levels of anti-thyroid antibodies should be checked in the lab because patients with anti-thyroid antibodies may have an autoimmune thyroid disease.
Hyperthyroidism occurs when the thyroid gland produces too many thyroid hormones, speeding up metabolism (Mathew & Rawla, 2021). As a result, patients experience weight loss, intolerance to heat, fatigue, and brittle hair, among others. The initial lab tests are similar to that of hypothyroidism, where the levels of the TSH hormone are examined. Low TSH levels are found in patients with hyperthyroidism (Mathew & Rawla, 2021). Both hypothyroidism and hyperthyroidism are caused by autoimmune thyroid diseases, such as Hashimoto's and Graves' diseases, respectively. However, hypothyroidism can be caused by iodine deficiency (Patil et al., 2021), while hyperthyroidism can be iodine-induced in cases when patients receive excess iodine (Mathew & Rawla, 2021).
Hypothyroidism is treated using hormone replacement medication, such as levothyroxine, to increase the amount of thyroid hormone production (Patil et al., 2021). This can alleviate the symptoms, but there is a risk of elevated thyroid hormone levels. Hyperthyroidism is treated using radioactive iodine and antithyroid therapies (Mathew & Rawla, 2021). These therapies slow down the production of thyroid hormones. Potential drug interactions include diabetes drugs, blood thinners, and cardiac disease drugs.
Question 3
Gastroesophageal reflux disease (GERD) is a digestive disorder that occurs when stomach contents flow back into the esophagus (Antunes et al., 2021). Patients experience symptoms such as chronic nausea and vomiting, heartburn, chronic cough, and chest pain, among others. The development of GERD has been attributed to delayed gastric emptying, impairment of the lower esophageal sphincter (LES), impaired acid clearance in the esophageal, and transient LES relaxation (Antunes et al., 2021). For diagnosis, the commonly used test is the upper gastrointestinal endoscopy, which shows the state of the esophageal mucosa (Clarrett & Hachem, 2018; Antunes et al., 2021). Treatment involves the use of proton pump inhibitors (PPIs) and histamine receptor antagonists (H2RAs), some of which are over-the-counter drugs (Antunes et al., 2021). These treatments reduce the secretion of gastric acid (Clarrett & Hachem, 2018). Potential drug interactions include NSAIDs and cephalosporins.
Peptic ulcer disease (PUD) occurs when open sores develop in the duodenum and stomach as a result of gastric acid production (Narayana et al., 2018; (Malik et al., 2021). It is caused by the Helicobacter pylori (H. pylori) bacterium as well as the use of NSAIDs. Symptoms include nausea and/or vomiting, heartburn, stomach pains, and weight loss. Similar to GERD, the commonly used test is the upper gastrointestinal endoscopy as well as stool antigen test for H. pylori. Also, PPIs are used to treat PUD to prevent acid production. However, in H.pylori-induced PUD, PPIs are combines with antibiotics. Drug interactions are also similar to those of GERD.
Question 4
Gout is a type of inflammatory arthritis caused by hyperuricemia and is more common in men(Fenando & Widrich, 2020). Gout causes joint...