. Still thinking about Sarah’s GI risks, what are the merits of changing to meloxicam or etodolac? 5. What are the merits of changing the NSAID to a COX-2 inhibitor (Celecoxib or Etoricoxib) in terms of reducing Sarah’s GI risks? 6. Would it be worthwhile to add a gastroprotective drug to Sarah’s NSAID? What are the options?
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Answer and analyze the case study questions.
Sarah goes to the local pharmacy and presents her prescription for a month’s supply of diclofenac. She is 63 years old and is not currently working. She has bilateral hip and knee osteoarthritis (OA) with occasional pain. She has been taking diclofenac 50mg three times/day for several years.
Six years ago she suffered a confirmed Helicobacter pylori-negative duodenal ulcer which has healed with conventional proton pump inhibitor (PPI) therapy. She suffers mild indigestion periodically but manages this herself with alginates and antacids (brought over-the-counter) when required. She also has hypertension and currently takes bendroflumethiazide 2.5 mg/day, ramipril 10 mg/day, and aspirin 75 mg/day; her blood pressure (BP)is maintained at around 142/92 mmHg. She does not smoke.
4. Still thinking about Sarah’s GI risks, what are the merits of changing to meloxicam or etodolac?
5. What are the merits of changing the NSAID to a COX-2 inhibitor (Celecoxib or Etoricoxib) in terms of reducing Sarah’s GI risks?
6. Would it be worthwhile to add a gastroprotective drug to Sarah’s NSAID? What are the options?
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- Answer and analyze the case study questions. Sarah goes to the local pharmacy and presents her prescription for a month’s supply of diclofenac. She is 63 years old and is not currently working. She has bilateral hip and knee osteoarthritis (OA) with occasional pain. She has been taking diclofenac 50mg three times/day for several years. Six years ago she suffered a confirmed Helicobacter pylori-negative duodenal ulcer which has healed with conventional proton pump inhibitor (PPI) therapy. She suffers mild indigestion periodically but manages this herself with alginates and antacids (brought over-the-counter) when required. She also has hypertension and currently takes bendroflumethiazide 2.5 mg/day, ramipril 10 mg/day, and aspirin 75 mg/day; her blood pressure (BP)is maintained at around 142/92 mmHg. She does not smoke. 7. Would using a COXib with a PPI reduce Sarah’s GI risk still further, compared with a traditional NSAID plus a PPI? 8. Moving on to consider Sarah’s CV risks, what…Clindamycin 5 mg/kg/day IV QID for infection is ordered. You have Clindamycin 150 mg/mL. The child weighs 44#. a. How many mg per dose will the child receive?Define the underlined terms in each case study.A 3-yr-old F/S golden retriever was presented with clinical signs of pruritus, abdominal dermatitis, and otitis. Skin scrapes were negative for external parasites. Ear cytology revealed a large number of yeast. The dog was referred to a dermatologist, who diagnosedatopy via intradermal skin testing. The dog was put on a hypoallergenic diet and was given hyposensitization injections. Medications were prescribed to control the pruritus and secondary pyoderma.1. pruritus _______________________________________2. dermatitis _______________________________________3. otitis _______________________________________4. skin scrapes _______________________________________5. dermatologist _______________________________________6. atopy _______________________________________7. intradermal skin testing _______________________________________8. hypoallergenic _______________________________________9. hyposensitization…
- An Independent Nurse Prescriber needs to prescribe treatment for an uncomplicated genital chlamydial infection, due to budget constraints she needs to prescribe the cheaper regime. The two treatment choices she has are between doxycycline or azithromycin. The respective dosages are: Doxycycline 100mg bd for seven days Or Azithromycin 1g stat The doxycycline costs £2.32 for a pack of 8 100mg capsules and the azithromycin costs £8.95 for a pack of 4 250mg capsules. What would be the exact saving the nurse would make if she prescribes the cheaper regime? units £ and penceA 67-year-old female lives in a non-fluoridated community. She has generalized 2-3 mm of recession and several crowns and fillings “from several years ago.” She has not had any new lesions since starting with your practice four years ago. She brushes two times per day with baking soda. She has now started taking antidepressants since the death of her husband six months ago. What are her risk factors for caries and what might be appropriate fluoride/recall treatment for her?.Case: This is a 14-year-old female patient who, after playing volleyball at school, begins with respiratory distress. She is taken to a nearby emergency, mistreated and sent to her house because she improved immediately.Her background is: frequent sinusitis and flu, she is also allergic to Penicillin.Sat. 97% 02 FR 28rper min. FC: 99lat.pormin. a) Possible diagnosesb) The handling in the Emergency was correct, explain why.c) What would be the corresponding studies to arrive at the diagnoses that you indicated?d) What therapeutic measures would you implement?
- A 3-day-postpartum client questions why she is to receive the rubella vaccine beforeleaving the hospital. Which of the following rationales should guide the nurse’s response?1. The client’s obstetric status is optimal for receiving the vaccine.2. The client’s immune system is highly responsive during the postpartum period.3. The client’s baby will be high risk for acquiring rubella if the woman does not receive the vaccine.4. The client’s insurance company will pay for the shot if it is given during the immediate postpartum period.Choose one (1) drug for pedia patients (pre term or full term) and apply the 10 R’s of medication. Follow the attached template. Choices: Vitamin K Erythromycin Hepatitis B*****Case Analysis Patient ID: A.C, a 4 year old female from Daraga Albay. History source – Mother 100 % reliability. Chief compliant: Persistent vomiting. History of present illness: 2 weeks PTA the patient experienced abdominal pain with painful urination. No fever, no vomiting, nor watery stool. No medication nor consult was done. 7 days PTA, the patient presented with an episode of vomiting with the passage of live worms. She also experiences abdominal pain without passage of stool for 2 days. 6 days PTA, the abdominal pain was persistent and with several episodes of vomiting but no passage of live worms. A few hours of PTA, the persistence of abdominal pain, increased frequency of vomiting, and presence of abdominal distention prompted them for a consult. Past medical history: (+) Bronchial asthma with last attack 1 month ago. (-) Heart disease. Family history: (+) DM, maternal and paternal side. (-) Cancer, cardiac disease, kidney, and asthma. Birth and Maternal history: 24…
- A male patient having a BMI of 35 was brought to the emergency department because of excessive frequent urination , drowsiness, vomiting, and diarrhea. Was on insulin daily until several days ago when he developed excessive thirst and frothy polyuria. For the past 3 days, he has also had headaches, myalgia, and a low grade fever. Diarrhea and vomiting began 1 day ago. The patient was advised some tests and the results were as follows Specific Gravity 1.012, Sodium 132 mEq/l, potassium 6 mEq/l pH 4.0, Alkaline Phosphatase 310 U/L, urine glucose +ve, Calcium 11 mg/dl, urine Acetone +ve, urine Protein +ve, FBS 560 mg/dl, urinary Oxalate +ve , GFR 55 ml/min, urine Acetoacetate +ve, BUN 31 mg/dL, Creatinine 3.2 mg/dL, Serum Ketones High, bicarbonate 15 mEq/l, Anion gap 13 Q:- Which lab results made you diagnose the above condition/sCase Study:A patient, ill with an infectious disease, is prescribed an oral bacteriostatic antibiotic. After 48 hours the nurse calls and tells the patient that they need to return to the hospital and receive an IM injection of a different, -cidal antibiotic as the pathogen is showing resistance to the first antibiotic. In addition the nurse states that there are only a few cases of this disease in the area as it is not common in Wisconsin. Question: What type of infectious disease is this patient suffering from? O Fungal O Prion infection O Viral Bacterial MacBook Air F5 F4 F3 & $ % 4 T Yrefer to the provided image 84. Which of the following may be an appropriate case definition based on the provided scenario?A. Illness among persons who consumed drinks at Bar XYZ within 9:00 pm of December 11, 2021 to 3:00am of December 12, 2021.B. Illness characterized by chills, cramps, diarrhea, fever, headache, myalgia, nausea, and vomitingamong persons who consumed drinks at Bar XYZ on December 11, 2021.C. Illness characterized by nausea, vomiting, cramps and diarrhea among persons who consumed drinksat Bar XYZ within 9:00 pm of December 11, 2021 to 3:00 am of December 12, 2021.D. Illness characterized by nausea, vomiting, cramps and diarrhea among persons who consumed rootbeer at Bar XYZ within 9:00 pm of December 11, 2021 to 3:00 am of December 12, 2021.85. Which of the following etiologic agents is consistent with information in the provided scenario?A. Cadmium; range of incubation period is 1to 60 mins; symptoms include nausea,vomiting, cramps, and diarrheaB. Enterotoxin of…