Reference no: EM133836441

Assignment:

Review the following case studies 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 and JNC 8 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.

CASE STUDY 1

JG is a 37-year-old male presenting with wheezing and shortness of breath. During his visit today, he reports having to use his albuterol 3 days per week over the past month. He reports being awakened by a cough six nights during the last month. His current medications include: salmeterol 50 mcg inhaler BID, albuterol MDI two puffs q4-6 hr PRN shortness of breath, prednisone 20mg qam, loratadine 10 mg daily, diphenhydramine 50 mg qhs prn. How would you step up asthma therapy for this patient (include complete medication order)? What medication changes would you make? What drug classification is salmeterol? Can it be used as monotherapy? What patient teaching and monitoring would you provide regarding the updated drug therapy plan?

CASE STUDY 2

KH is a 48-year-old male diagnosed with type II diabetes 1 year ago. He has controlled his blood glucose through dietary changes. He has hypertension and is currently on lisinopril 10 mg po daily. He has no known allergies. His lab work today includes: fasting BG is 175 mg/dL; HgA1C = 7.5%. Basic Metabolic Profile (BMP) is normal except for Cr 1.8 and eGRF 28. What treatment plan would you implement for KH (include complete medication order)? What education would you provide regarding his treatment plan? How would you monitor the effectiveness of this plan? What is the goal A1C?

CASE STUDY 3

AT is a 63-year-old female that presents to the clinic today with early-onset Alzheimer's Disease. What would you prescribe? Consider her labs and provide an updated drug therapy plan. Include complete medication orders. How would you monitor drug therapy? Labs: TSH 3.9 mU/L, vitamin D 24 ng/mL, B12 450 pg/mL, Hb 12.5 g/dL, blood glucose = 100 mg/dL, HgA1C = 5.4% Medications include: insulin glargine 20 units once daily qhs, insulin lispro 6 units before each meal (adjusting based on carbohydrate intake)

CASE STUDY 4

HM is a 42 year-year-old female seeking evaluation for feelings of fullness, bloating and acid reflux with symptoms worse at night. HM eats fast food once a day and consumes 2 cups of coffee a day. She drinks alcohol socially on weekends. PMH includes asthma, diabetes and hypertension. Her blood pressure today is 142/85. Current medications include prn famotidine, prn albuterol, Pulmicort Flexhaler 90 mcg 2 inhalations twice daily, cetirizine 10 mg daily, bisoprolol 5 mg po daily and metformin 1000 mg po daily with food. How would you improve her drug therapy plan? What changes would you make (include complete medication orders)? What information would you provide to the patient at her visit? Can a patient take a H2 blocker and PPI at the same time?

Please include 4 or more intext citations and references.