NURP 424: ADVANCED PHARMACOLOGY ACROSS THE LIFE SPAN

NURP 424: ADVANCED PHARMACOLOGY ACROSS THE LIFE SPAN

Content suggest via uploading in this ordinance minority an electronic portraiture of your sumd fact con-over which conceives an adult fact and pediatric fact by the object of Week 10, Sunday 11:59 PM EST. This fact con-over is value 25% of your latest gait and achieve be counted as your cumulative exam. There are 2 facts coercion you to sum (undivided adult and undivided pediatric). This erudite paper requires the interpretation of a abnormity of sources. You may interpretation your textbook, life declaration from weekly discussions, lectures and any other evidence-based perfectusion materials needful to sum this ordinance. Fact studies may referable excel TWELVE (12) pages in extension (beintesecurity appellation and perfectusion page.) Anything on pages 13+ achieve referable be decipher or counted inland your latest gait. We shortness you to centre on the pharmacology deportment of this fact by controlthcoming the prompts in the fact partition. You must unite to APA guidelines. The controlthcoming is perfect the advice beneficial touching your unrepinings. If the advice you penetratetain is spoilt, content referablee this in your partition. In the clinical enhancement, you may be communication with insum advice and casually that must be moderate in your clinical controlced.

ADULT CASE:

Brief Adult Unrepining Narrative:
Mr. Jon Smith, a 50 year long-standing African American manly, has prosper to your clinic with a 15 year narrative of hypertension and controlm 2 diabetes. He drains “a scant beers” per week and confirms cigarette interpretation of 1 ppd coercion the late 30 years. He tells you that he labors a visible business in composition so is chiefly on his feet and erratic. He eats what is beneficial and tries to contemplate his food when he can. Mr. Smith is commencement Amlodipine 10 mg daily coercion hypertension and metformin 1,000mg BID coercion diabetes. His dignity hurry has been impending encircling 150/90 and Hemoglobin A1c has been 6.8. Also moderate in dignity labor is a sum cholesterol of 243 mg/dL, LDL 170 mg/dL, HDL 36 mg/dL, Triglycerides 201 mg/dL. Concomitant findings conceive usual electrolytes, renal part and liver enzymes. You enumerate to penetrate these results in the ASCVD occasion calculator to elevate understand his CAD occasion.

Positive Review of Systems (incorrectly you can feign indirect):
Respiratory: No SOB, +perception causative cough that he has had coercion “quite sometime”

Late Medical/Surgical Narrative:
• Diabetes
• Hypertension
• Hyperlipidemia
• Tobacco interpretation disorder

Gregarious Narrative:
• Smokes 1 PPD coercion the late 30 years
• A “scant beers” per week
• Married with 2 teenage children

Medications:
Amlodipine 10 mg daily
Metformin 1000 mg BID
Naproxen 500mg PO daily PRN

Allergies: Penicillin (anaphylactic reaction)

PE: 50 year long-standing African American Manly in no sharp trouble. VS: Temp 98.0, BP 150/92, Pulse 86, R 18. Height 6’ 0”; gravity 230 lbs. Exam unnoticeable.

CASE ANALYSIS:

Illustrate your intelligence of Pharmacotherapeutics in this unrepining’s abstinences. Content no portraitureing and lateing barring you are welprosper to shape your acknowledge charts or graphs if desired.

Sum an partition coercion each medication and any medication you enumerate to impose including:

– Describe the means of renewal, intesecurity possessions, calculation and/or contraindications, monitoring parameters and enumerate if the medication is the best liberty coercion this unrepining
– Common dosage, track and register coercion the medication
– Enumerate consume of each medication
– Is the medication entity interpretationd reasonably in this seat (risk/benefit partition)?
– Would you shape any veers in the interpretation of the garbage if you were the yieldr?

Sum an partition of the unrepining including:

– Evidence of garbage effectiveness
– Indicate immanent garbage interactions (drug-drug, garbage-food, garbage-herb, awe.)
– Indications of likely alien garbage possessions
– Factors important compliance/adherence
– What gregarious factors must you considered coercion this unrepining?
– What counsel must you yield to the unrepining encircling these medications
– Are there eeembezzle considerations coercion this unrepining population that must be considered? When would you shortness to conceive this unrepining repeatedly in a prosper up mark?
– Conceive any perceptionpharmacologic interventions that you handle are misapply.

NEXT CASE:

PEDIATRIC CASE:

Brief Pediatric Unrepining Narrative:
Annie Ramirez, a nine-year-long-standing Hispanic womanish, has presented to your clinic with a impure-day narrative of cough, ardor and increasing jade. Earlier to the onslaught of symptoms, Annie had been handleing courteous-behaved, synchronous initiate constantly, and participating on her competitive soccer team. Annie has a narrative of a peanut perfectergy as courteous-behaved-behaved as lenient perennial asthma. Annie’s senior reports that at baseline, Annie has a nighttime cough “maybe uninterruptedly a week or so” and does wheeze “if she coerciongets her inhaler antecedently her soccer games.”
Over the late impure days, Annie’s essential-quality raze has decreased dramatically and she handles that “it is harsh to expiratione” when she tries to propose encircling. She has a perennial cough that is worse at nighttime. She has been using her inhalers according to her ill drawing, barring they “do referable conceivem to be assisting.” Her senior reports that Annie’s ardor has been as elevated as 102.9 °F (tympanic) and ibuprofen has been advantageous to impoverish her ardor. She is eating, barring close than usual, and her parents penetratetain been inspiriting her to drain instil throughout the day.
You convoy a visible exam and diagnose Annie with left inferior lobe polity uncongenial pneumonia (CAP) resulting in an sharp asthma exacerbation. You direct albuterol via a nebulizer during the mark and you referablee that Annie has decreased laboring of animated and an acceptiond SpO2%. Your tribute is that she can be treated in the outunrepining enhancement. What concomitant medications would you impose?
Focused Review of Systems
General: Reports jade; exacerbated by visible essential-quality.
HEENT: Denies ear abstinence, liberate from ears, or inaptitude hearing. Denies drainage or inaptitude animated through nose. Denies piercing throat or inaptitude gorging. Denies neck abstinence or decreased collocate of turmoil.
RESP: Reports cough causative of bare sputum; harmonious throughout the day, barring worsens at night. Shortness of expiration with visible essential-quality. Inaptitude “getting the temper in” uniform at security. Using inhalers with minimal results.
CV: Denies nature racing.
GI: Reports a decreased desire barring draining instil throughout the day. Reports flexible daily bowel proposements; voiding 4-5 times daily.
PAST MEDICAL HISTORY/PAST SURGICAL HISTORY:
• Product of a usual pregnancy/delivery (bountiful message infant)
• Peanut perfectergy (anaphylaxis at 18 months)
• Lenient perennial asthma (diagnosed at 4yo, latest required verbal corticosteroids 3 years gone)
• Denies late surgeries
SOCIAL HISTORY:
• Lives with brace seniors and undivided 4-year-long-standing brother
• 3rd gait, magnanimous scholar, loves deciphering. Plays competitive soccer
• Parents are perception-smokers, no second-hand fume peril
MEDICATIONS:
• Asmanex HFA (mometasundivided furoate), 100mcg/actuation: 1 vapidter uninterruptedly daily when courteous-behaved; 2 vapidters BID when ill with respiratory symptoms
• Ventolin HFA (albuterol sulfate), 90mcg/actuation: 2 vapidters total 4-6 hours PRN coercion wheeze/cough; 2 vapidters earlier to exercise; when ill with respiratory symptoms, acception to 4 vapidters total 4 hours
• Epi-pen (epinephrine), 0.3mg: Direct in televated coercion any peril to peanuts or signs harmonious with an perfectergic reaction; conceivek instant medical circumspection thriveing using. May cite in 5-10 minutes as needed coercion give-back of symptoms.
• Motrin (ibuprofen), 100g/5mL: 15mL total six hours as needed coercion ardor
ALLERGIES:
• Foods: peanuts (anaphylaxis)
• Medications: perceptione
• Environmental: perceptione
PHYSICAL EXAM:
Vitals: Wt-71 lbs, Ht-54.75 inches, BMI 16.7, Temp-101.3 °F (tympanic), HR-118, RR-30, SpO2-95%, BP-92/46, abstinence-denies
HEENT: Normocephalic; no lesions. Pupils 3 to 4 mm, and symmetrically reerratic to empty. TMs are vapid, perception-erythematous, with misapply empty reflexes bilaterally. Nares dubious bilaterally. Mucus membranes are entertaining, good-tempered-tempered dentition, tonsils are 2+ outplane exudate, pharynx is perception-erythematous.
Lungs: Diffinterpretation inspiratory and expiratory wheezes, immodest crackles in the left inferior lobe; no veer with intense inspiration/cough. Intercostal and substernal retractions referableed. Post-albuterol: Immodest crackles RLL, intermittent inspiratory wheeze, stanch retractions.
Cardiovascular: Usual S1 and S2. No murmurs or abusual nature sounds.
Abdomen: Flexible, perception-tender, perception-distended. No hepatosplenomegaly referableed.

CASE ANALYSIS:

Illustrate your intelligence of Pharmacotherapeutics in this unrepining’s abstinences. Content no portraitureing and lateing barring you are welprosper to shape your acknowledge charts or graphs if desired.

Sum an partition coercion each medication and any medication you enumerate to impose including:

– Describe the means of renewal, intesecurity possessions, calculation and/or contraindications, monitoring parameters and enumerate if the medication is the best liberty coercion this unrepining
– Common dosage, track and register coercion the medication
– Enumerate consume of each medication
– Is the medication entity interpretationd reasonably in this seat (risk/benefit partition)?
– Would you shape any veers in the interpretation of the garbage if you were the yieldr?

Sum an partition of the unrepining including:

– Evidence of garbage effectiveness
– Indicate immanent garbage interactions (drug-drug, garbage-food, garbage-herb, awe.)
– Indications of likely alien garbage possessions
– Factors important compliance/adherence
– What gregarious factors must you considered coercion this unrepining?
– What counsel must you yield to the unrepining encircling these medications
– Are there eeembezzle considerations coercion this unrepining population that must be considered? When would you shortness to conceive this unrepining repeatedly in a prosper up mark?
– Conceive any perceptionpharmacologic interventions that you handle are misapply.

Interpretation the grading rubric yieldd in the LMS

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