Explore our Ultimate FREE detailed guide on the NURS-6521 Advanced Pharmacology W1: Assignment 1: Case Studies.
Instructions of NURS-6521 Advanced Pharmacology W1
Directions: For each of the scenarios below, answer the questions below using clinical practice guideline where applicable. Explain the problem and explain how you would address the problem. If prescribing a new drug, write out a complete medication order just as you would if you were completing a prescription. Use at least 3 sources for each scenario and cite sources using APA format.
A 52-year-old man was recently discharged from the hospital following treatment for atrial fibrillation. He was discharged on Warfarin 5 mg po q day and Amiodarone 200 mg tid. His INR is 8.8. What interaction has occurred with these 2 medications? What changes in his medications would you make?
A 44-year-old women is currently taking Glipizide and Phenytoin. She has a new prescription for Ceftriaxone. All three medications are known to be highly protein bound. What effect does protein binding have on drug availability? How would you manage this patient’s medication?
Name two drugs that are highly affected by the first pass effect. As a prescriber, what actions would you take in prescribing these drugs to counter the first pass effect?
James is a 49-year-old male that was prescribed atenolol for his high blood
pressure. James states that he only occasionally takes the medication because he does not like the side effects. What information would you provide to the patient at his visit? How would you manage his medication?
ASSIGNMENT 1: CASE STUDIES
Case studies are a useful way for you to apply your knowledge of pharmacokinetics and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.
For this Assignment, you evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
To Prepare:
- 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 to support your answer and cite them in APA format.
BY DAY 7 OF WEEK 1
Submit the Assignment.
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Step-By-Step Guide NURS-6521 Advanced Pharmacology W1: Assignment 1: Case Studies
Introduction to NURS-6521 Week 1: Assignment 1: Case Studies
Welcome to NURS-6521 Advanced Pharmacology W1: Assignment 1: Case Studies. In this week’s assignment, you will apply your knowledge of pharmacokinetics and pharmacodynamics to real-world scenarios. This exercise aims to enhance your clinical decision-making skills and understanding of drug interactions, protein binding, the first-pass effect, and patient education regarding medication adherence. You will evaluate drug treatment plans, justify your recommendations, and ensure they align with best practices and ethical/legal guidelines.
A 52-year-old man was recently discharged from the hospital following treatment for atrial fibrillation. He was discharged on Warfarin 5 mg po q day and Amiodarone 200 mg tid. His INR is 8.8. What interaction has occurred with these two medications? What changes in his medications would you make?
Scenario 1: Atrial Fibrillation and Medication Interaction
- Describe how Warfarin and Amiodarone interact and the resulting impact on the patient’s INR.
- Research how Amiodarone increases Warfarin levels, leading to a high INR.
- Adjust Medication: Propose changes to the medication regimen to address the high INR.
- Consider lowering the Warfarin dose or adjusting Amiodarone timing.
- Write out a new prescription based on your adjustments.
Example
A 52-year-old man was recently discharged from the hospital following treatment for atrial fibrillation. He was discharged on Warfarin 5 mg po q day and Amiodarone 200 mg tid. His INR is 8.8. The interaction between Warfarin and Amiodarone is significant because Amiodarone inhibits the metabolism of Warfarin, leading to elevated Warfarin levels and an increased INR (Elliott et al., 2023).
A 44-year-old woman is currently taking Glipizide and Phenytoin. She has a new prescription for Ceftriaxone. All three medications are known to be highly protein-bound. What effect does protein binding have on drug availability? How would you manage this patient’s medication?
Scenario 2: Protein Binding and Drug Availability
- Discuss how protein binding affects drug availability and potential interactions.
- Describe the competition for binding sites and its impact on drug efficacy.
- Manage Medication: Propose a management plan to avoid adverse interactions.
- Consider timing adjustments or alternative medications.
- Complete Medication Order: Write a detailed prescription order.
- Be courteous and constructive in your responses, avoiding any language that could be perceived as disrespectful.
Example
A 44-year-old woman is currently taking Glipizide and Phenytoin and has a new prescription for Ceftriaxone. All three medications are highly protein-bound, meaning they compete for binding sites on plasma proteins. This competition can increase the free (active) concentrations of the drugs, potentially leading to toxicity or decreased efficacy. To manage this patient’s medication, it is crucial to monitor drug levels closely and adjust dosages as necessary to maintain therapeutic levels without causing adverse effects (Wicha et al., 2021).
Name two drugs that are highly affected by the first-pass effect. As a prescriber, what actions would you take in prescribing these drugs to counter the first-pass effect?
Scenario 3: First Pass Effect
- List two drugs significantly impacted by the first-pass effect.
- Tip: Common examples include propranolol and morphine.
- Prescribing Actions: Describe strategies to mitigate the first-pass effect.
- Tip: Consider alternative routes of administration (e.g., IV, sublingual).
Example
Two drugs highly affected by the first-pass effect are propranolol and morphine. The first-pass effect significantly reduces their bioavailability when administered orally. As a prescriber, to counter this effect, alternative routes of administration should be considered. For propranolol, using an IV formulation in acute settings can bypass the first-pass metabolism, ensuring that the drug reaches therapeutic levels more quickly (Kalam et al., 2020). For morphine, sublingual or IV routes can be used to achieve the desired analgesic effect without significant loss of drug efficacy through metabolism in the liver
James is a 49-year-old male that was prescribed atenolol for his high blood pressure. James states that he only occasionally takes the medication because he does not like the side effects. What information would you provide to the patient at his visit? How would you manage his medication?
Scenario 4: Patient Education and Medication Adherence
- Explain the importance of medication adherence and potential risks of non-compliance.
- Highlight the long-term benefits and address side effect concerns.
- Manage Medication: Adjust the treatment plan to improve adherence.
- Consider alternative medications or dose adjustments.
- Complete Medication Order: Provide a revised prescription.
Example
James, a 49-year-old male prescribed atenolol for hypertension, reports that he only occasionally takes his medication due to side effects. In this case, it is crucial to educate James on the importance of regular medication adherence to control blood pressure and prevent complications such as stroke or heart attack (Siddiqui et al., 2023). Discussing the potential long-term benefits and addressing his concerns about side effects is essential.
Closing
In the NURS-6521 Advanced Pharmacology W1: Assignment 1: Case Studies, you will hone your ability to evaluate and adjust drug treatment plans, ensuring they are safe, effective, and tailored to each patient’s unique needs. By applying clinical practice guidelines, writing accurate medication orders, and supporting your decisions with credible sources, you will demonstrate a comprehensive understanding of pharmacokinetics, pharmacodynamics, and the ethical/legal aspects of prescribing. This Owlisdom assignment will strengthen your clinical acumen and prepare you for real-world patient care challenges. In the next module of NURS-6521, we will discuss Advanced Pharmacology Assignment 2: Practicum Manual.
References
Elliott, A. D., Middeldorp, M. E., Van Gelder, I. C., Albert, C. M., & Sanders, P. (2023). Epidemiology and modifiable risk factors for atrial fibrillation. Nature Reviews Cardiology, 20(6), 404–417.
Kalam, M. N., Rasool, M. F., Rehman, A. U., & Ahmed, N. (2020). Clinical pharmacokinetics of propranolol hydrochloride: A review. Current Drug Metabolism, 21(2), 89–105.
Siddiqui, M. F., Rasheed, M., Alwazzan, A., & Sarwar, S. (2023). Effectiveness of Atenolol on the Basis of Pattern of Side Effects in Hypertensive Patients: Effectiveness of Atenolol in Hypertensive Patients. DIET FACTOR (Journal of Nutritional and Food Sciences), 32–36.
Wicha, S. G., Märtson, A., Nielsen, E. I., Koch, B. C. P., Friberg, L. E., Alffenaar, J., Minichmayr, I. K., & the International Society of Anti‐Infective Pharmacology (ISAP), the PK/PD study group of the European Society of Clinical Microbiology, Infectious Diseases (EPASG). (2021). From Therapeutic Drug Monitoring to Model‐Informed Precision Dosing for Antibiotics. Clinical Pharmacology & Therapeutics, 109(4), 928–941. https://doi.org/10.1002/cpt.2202
