Case studies are a useful way for you to apply your knowledge of pharmacokinetic and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.
For your week 7 assignment, evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.
Directions: For each of the scenarios below, answer the questions using your required learning resources, Medscape, and clinical practice guidelines (ie AHA, ACC, ADA, GINA). When recommending medications, write out a complete prescription for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, # dispensed (days supply), refills, special instructions etc. Also state if you would continue, discontinue or taper the patient’s current medications (if applicable). Use at least 3 sources for each scenario and cite sources using APA format. LIST REFERENCES AFTER EACH SCENARIO.
SCENARIO 1
What are the errors in the following prescriptions (1 per prescription)? Rewrite each prescription correctly. What is each medication’s classification and mechanism of action (MOA)?
· fentanyl transdermal patch 12 mcg/hr Apply 1 patch to skin every 72 hours #10 patches 1 RF
· Skyrizi 600 mg/10 mL IV infused over 1 hour at weeks 0, 4, 8 and 12 for Crohn’s disease #1 vial 3 RF
· allopurinol 300 mg PO QID #120 0 RF
· adalimumab (Humira) 120 mg SQ inject every other week #2 syringes 1 RF
· bupropion XL 150 mg PO BID for smoking cessation #60 1 RF
SCENARIO 2
Zolpidem has a half-life of 3 hours. If a patient takes 10 mg at 21:00, what will the blood level be at 06:00? Name 3 antidepressants/antipsychotics you might prescribe for patients with co-existing depression and insomnia. What is their MOA? Include complete medication orders and patient monitoring for each of the 3 medications.
SCENARIO 3
Match the following patients to the most appropriate antidepressant for their symptom cluster. Each medication option is used once. Include MOA, medication side effects, and a medication order for at least 1 of the patients.
Patient Presentation
1 fibromyalgia, insomnia, no depression
2 diabetic neuropathy, fatigue, depression
3 postherpetic neuralgia, poor appetite, insomnia
4 chronic musculoskeletal pain, anxiety, hot flashes
5 fibromyalgia, no mood disorder, prefers non-sedating
Medication options:
A. amitriptyline
Medication options:
B. duloxetine
C. mirtazapine
D. venlafaxine
E. milnacipran
SCENARIO 4
OH is an 9-year-old male brought in by his father due to concerns about behavior and school performance. His teacher reports that OH is frequently out of his seat, talks excessively, blurts out answers, and has difficulty completing tasks and following directions. At home, he often loses homework, seems forgetful, and struggles to stay focused on activities like reading. Growth and development are age-appropriate. He sleeps about 9 hours per night but still wakes up feeling tired. There are no signs of anxiety, depression, or other mood disorders. What is the most likely diagnosis? What is an appropriate first-line medication (include complete medication order)? What monitoring parameters should be considered during treatment?
NURS_6521_Week7_Assignment_Rubric
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NURS_6521_Week7_Assignment_Rubric
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Criteria
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Ratings
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Pts
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This criterion is linked to a Learning OutcomeScenario 1:
Appropriate medication is prescribed or changed. Rationale provided and
includes current literature to support decision. All aspects of the patient
history are considered in making the medication selection.
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15 to >11.0 ptsExcellentMedication
selected is appropriate and considers all of the unique patient
characteristics. Rationale for selection is clear, complete, and appropriate.
11 to >7.0 ptsGoodMedication selected
might be appropriate but conflicts with the unique patient characteristics.
Rationale for selection is clear but lacks discussion about potential
prescribing issues.
7 to >3.0 ptsFairMedication selected
is not appropriate for this patient unique characteristics. Rationale
provided is not correct or is flawed in applying the medication to this
patient.
3 to >0 ptsPoorMedication selected is
inappropriate or would not be provided based on patient unique
characteristics.
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15 pts
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This criterion is linked to a Learning OutcomeScenario 1:
Written medication orders include all 5 aspects required for a valid order.
The order is complete, accurate, and appropriate.
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3 ptsCompleteWritten medication orders
includes all 5 aspects required for a valid order. The order is complete,
accurate, and appropriate.
0 ptsPoorThe prescription is incomplete.
Aspects of a complete order are missing. The order is either incomplete,
inaccurate, or inappropriate.
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3 pts
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This criterion is linked to a Learning OutcomeScenario 1:
References for the scenario are within past 5 years and include the
appropriate clinical practice guideline if applicable.
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4 ptsExcellentReferences for the scenario are
within past 5 years and include the appropriate clinical practice guideline
if applicable. Correct APA format is used.
3 ptsGoodReferences for the scenario are
within past 5 years but do not include the appropriate clinical practice
guideline if applicable. Contains a few (1 or 2) APA format errors.
2 ptsFairReferences for the scenario are not
from within the past 5 years or do not reflect the content of this scenario
and do not include the appropriate clinical practice guideline if applicable.
Contains several (3 or 4) APA format errors.
0 ptsPoorNo references are included.
References do not reflect the content of this scenario. Appropriate clinical
practice guideline is not include. Contains many (≥ 5) APA format errors.
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4 pts
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This criterion is linked to a Learning OutcomeScenario 1:
Written Expression and Formatting – English writing standards: Correct
grammar, mechanics, and proper punctuation
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3 ptsExcellentUses correct grammar, spelling,
and punctuation with no errors.
2 ptsGoodContains a few (1 or 2) grammar,
spelling, and punctuation errors.
1 ptsFairContains several (3 or 4) grammar,
spelling, and punctuation errors.
0 ptsPoorContains many (≥ 5) grammar,
spelling, and punctuation errors that interfere with the reader’s understanding.
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3 pts
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This criterion is linked to a Learning OutcomeScenario 2:
Appropriate medication is prescribed or changed. Rationale provided and
includes current literature to support decision. All aspects of the patient
history are considered in making the medication selection.
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15 to >11.0 ptsExcellentMedication
selected is appropriate and considers all of the unique patient
characteristics. Rationale for selection is clear, complete, and appropriate.
11 to >7.0 ptsGoodMedication selected
might be appropriate but conflicts with the unique patient characteristics.
Rationale for selection is clear but lacks discussion about potential
prescribing issues.
7 to >3.0 ptsFairMedication selected
is not appropriate for this patient unique characteristics. Rationale
provided is not correct or is flawed in applying the medication to this
patient.
3 to >0 ptsPoorMedication selected is
inappropriate or would not be provided based on patient unique
characteristics.
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15 pts
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This criterion is linked to a Learning OutcomeScenario 2:
Written medication orders include all 5 aspects required for a valid order.
The order is complete, accurate, and appropriate.
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3 ptsCompleteWritten medication orders
includes all 5 aspects required for a valid order. The order is complete,
accurate, and appropriate.
0 ptsPoorThe prescription is incomplete.
Aspects of a complete order are missing. The order is either incomplete,
inaccurate, or inappropriate.
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3 pts
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This criterion is linked to a Learning OutcomeScenario 2:
References for the scenario are within past 5 years and include the
appropriate clinical practice guideline if applicable.
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4 ptsExcellentReferences for the scenario are
within past 5 years and include the appropriate clinical practice guideline
if applicable. Correct APA format is used.
3 ptsGoodReferences for the scenario are
within past 5 years but do not include the appropriate clinical practice guideline
if applicable. Contains a few (1 or 2) APA format errors.
2 ptsFairReferences for the scenario are not
from within the past 5 years or do not reflect the content of this scenario
and do not include the appropriate clinical practice guideline if applicable.
Contains several (3 or 4) APA format errors.
0 ptsPoorNo references are included.
References do not reflect the content of this scenario. Appropriate clinical
practice guideline is not include. Contains many (≥ 5) APA format errors.
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4 pts
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This criterion is linked to a Learning OutcomeScenario 2:
Written Expression and Formatting – English writing standards: Correct
grammar, mechanics, and proper punctuation
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3 ptsExcellentUses correct grammar, spelling,
and punctuation with no errors.
2 ptsGoodContains a few (1 or 2) grammar,
spelling, and punctuation errors.
1 ptsFairContains several (3 or 4) grammar,
spelling, and punctuation errors.
0 ptsPoorContains many (≥ 5) grammar,
spelling, and punctuation errors that interfere with the reader’s understanding.
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3 pts
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This criterion is linked to a Learning OutcomeScenario 3:
Appropriate medication is prescribed or changed. Rationale provided and
includes current literature to support decision. All aspects of the patient
history are considered in making the medication selection.
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15 to >11.0 ptsExcellentMedication
selected is appropriate and considers all of the unique patient
characteristics. Rationale for selection is clear, complete, and appropriate.
11 to >7.0 ptsGoodMedication selected
might be appropriate but conflicts with the unique patient characteristics.
Rationale for selection is clear but lacks discussion about potential
prescribing issues.
7 to >3.0 ptsFairMedication selected
is not appropriate for this patient unique characteristics. Rationale
provided is not correct or is flawed in applying the medication to this
patient.
3 to >0 ptsPoorMedication selected is
inappropriate or would not be provided based on patient unique
characteristics.
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15 pts
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This criterion is linked to a Learning OutcomeScenario 3:
Written medication orders include all 5 aspects required for a valid order.
The order is complete, accurate, and appropriate.
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3 ptsCompleteWritten medication orders
includes all 5 aspects required for a valid order. The order is complete,
accurate, and appropriate.
0 ptsPoorThe prescription is incomplete.
Aspects of a complete order are missing. The order is either incomplete,
inaccurate, or inappropriate.
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3 pts
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This criterion is linked to a Learning OutcomeScenario 3:
References for the scenario are within past 5 years and include the
appropriate clinical practice guideline if applicable.
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4 ptsExcellentReferences for the scenario are
within past 5 years and include the appropriate clinical practice guideline
if applicable. Correct APA format is used.
3 ptsGoodReferences for the scenario are
within past 5 years but do not include the appropriate clinical practice
guideline if applicable. Contains a few (1 or 2) APA format errors.
2 ptsFairReferences for the scenario are not
from within the past 5 years or do not reflect the content of this scenario
and do not include the appropriate clinical practice guideline if applicable.
Contains several (3 or 4) APA format errors.
0 ptsPoorNo references are included.
References do not reflect the content of this scenario. Appropriate clinical
practice guideline is not include. Contains many (≥ 5) APA format errors.
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4 pts
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This criterion is linked to a Learning OutcomeScenario 3:
Written Expression and Formatting – English writing standards: Correct
grammar, mechanics, and proper punctuation
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3 ptsExcellentUses correct grammar, spelling,
and punctuation with no errors.
2 ptsGoodContains a few (1 or 2) grammar,
spelling, and punctuation errors.
1 ptsFairContains several (3 or 4) grammar,
spelling, and punctuation errors.
0 ptsPoorContains many (≥ 5) grammar,
spelling, and punctuation errors that interfere with the reader’s
understanding.
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3 pts
|
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This criterion is linked to a Learning OutcomeScenario 4:
Appropriate medication is prescribed or changed. Rationale provided and
includes current literature to support decision. All aspects of the patient
history are considered in making the medication selection.
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15 to >11.0 ptsExcellentMedication
selected is appropriate and considers all of the unique patient
characteristics. Rationale for selection is clear, complete, and appropriate.
11 to >7.0 ptsGoodMedication selected
might be appropriate but conflicts with the unique patient characteristics.
Rationale for selection is clear but lacks discussion about potential
prescribing issues.
7 to >3.0 ptsFairMedication selected
is not appropriate for this patient unique characteristics. Rationale
provided is not correct or is flawed in applying the medication to this
patient.
3 to >0 ptsPoorMedication selected is
inappropriate or would not be provided based on patient unique
characteristics.
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15 pts
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This criterion is linked to a Learning OutcomeScenario 4:
Written medication orders include all 5 aspects required for a valid order.
The order is complete, accurate, and appropriate.
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3 ptsCompleteWritten medication orders
includes all 5 aspects required for a valid order. The order is complete,
accurate, and appropriate.
0 ptsPoorThe prescription is incomplete.
Aspects of a complete order are missing. The order is either incomplete,
inaccurate, or inappropriate.
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3 pts
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This criterion is linked to a Learning OutcomeScenario 4:
References for the scenario are within past 5 years and include the
appropriate clinical practice guideline if applicable.
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4 ptsExcellentReferences for the scenario are
within past 5 years and include the appropriate clinical practice guideline
if applicable. Correct APA format is used.
3 ptsGoodReferences for the scenario are
within past 5 years but do not include the appropriate clinical practice
guideline if applicable. Contains a few (1 or 2) APA format errors.
2 ptsFairReferences for the scenario are not
from within the past 5 years or do not reflect the content of this scenario
and do not include the appropriate clinical practice guideline if applicable.
Contains several (3 or 4) APA format errors.
0 ptsPoorNo references are included.
References do not reflect the content of this scenario. Appropriate clinical
practice guideline is not include. Contains many (≥ 5) APA format errors.
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4 pts
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This criterion is linked to a Learning OutcomeScenario 4:
Written Expression and Formatting – English writing standards: Correct
grammar, mechanics, and proper punctuation
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3 ptsExcellentUses correct grammar, spelling,
and punctuation with no errors.
2 ptsGoodContains a few (1 or 2) grammar,
spelling, and punctuation errors.
1 ptsFairContains several (3 or 4) grammar,
spelling, and punctuation errors.
0 ptsPoorContains many (≥ 5) grammar,
spelling, and punctuation errors that interfere with the reader’s
understanding.
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3 pts
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Total Points: 100