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- Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomniaWhich of his medications might be causing the insomnia? How could this be addressed?Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia1. Discuss possible reasons this patient fell.2. List common side effects of Levodopa/Carbidopa3. He states that he doesn’t think his antidepressant is working. How will you address his concern?4. Which of his medications might be causing the insomnia? How could this be addressed?5. List some general education points regarding sleep hygiene.6. Do you have…Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 1. His wife tells you that he has started having hallucinations. Which medication might be causing this?Discuss why this happens.
- Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 5. List some general education points regarding sleep hygienePatient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia Do you have any concerns about his pain medication?Patient is a 55 year old female with a diagnosis of diabetes. She was diagnosed when she was 50 aftershe changed jobs and became more sedentary and which also resulted in a poor diet. She currentlyoverweight with a BMI of 32.Allergies NKDACurrent MedicationsMetformin 1000 mg BIDLisinopril 10 mg once dailyPMH Propranolol 10 mg TIDDMHTNList the long term complications of DM
- Women’s Health Prescribing Case Ann is a 57 y/o female who presents today with c/o vaginal dryness and dyspareunia. She says that this has been an issue for the last 2 years or so, but it has gotten worse. She went through natural menopause at the age of 53—and did not take any oral estrogens—she said it was her preference not to, and that she really did not have any systemic signs/symptoms of menopause—just the vaginal dryness for the last 2 years or so. She says that she has used OTC products without benefit—and she uses Astroglide or some type of lubricant when she is sexually active with her husband—but it is still uncomfortable because she just thinks her tissue are so dry. Ann tells you that she usually does not have any itching or discharge but has in the last few days—which she attributes to a recent round of Amoxicillin for a tooth infection. So she thinks she may need something for that also—she has not used any OTC meds for the discharge. Ann is healthy—she takes…Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week.u Hx COPD, cor pulmonaleu It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindingsu Pulse – Regular, rapid…Patient is a 55 year old female with a diagnosis of diabetes. She was diagnosed when she was 50 aftershe changed jobs and became more sedentary and which also resulted in a poor diet. She currentlyoverweight with a BMI of 32.Allergies NKDACurrent MedicationsMetformin 1000 mg BIDLisinopril 10 mg once dailyPMH Propranolol 10 mg TIDDMHTN1. Despite her medication regimen, her blood sugar has been very, very high and her physician decidedto start a long acting insulin. Which insulins are long acting?
- Provide a possible diagnosis for the following endocrinology related case. During the term break, one of your aunties’ come to stay with your family at the city. She is a 55 year old, married woman who works as a civil clerk of the Regional Trial Court of their province. Her main agenda is to consult a doctor or two for the various health issues she currently has. She has many signs and symptoms. She drinks water too much because she is always thirsty, and urinates too often. She also eats more frequently that she used to. But by looking at her, she seems to be pretty slim. You wouldn’t really believe she eats too frequently unless you saw her regularly. Now that she is staying with you, you observe that she has a very sedentary lifestyle, plus yes, she does eat many times in a day. Since you have been close to her from childhood, you agreed to share your room with her. You are a light sleeper, and this made you realize that she wakes up at least 3x every night just to urinate. She…Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…