PHAR 1000 – Basic Pharmocotherapeutics
Eileen J. Arellano
Norquest College
Practical Nurse- Section D01
PHAR 1000 Written Assignment
Heather Zirk RN, BN
September 15, 2014 CASE STUDY:
Name of Client: Maggie Sears
Age: 66 years old
Primary Diagnosis: Cellulitis to left leg
Secondary Diagnosis: Depression Osteoporosis Type 2 Diabetes Mellitus
Past Surgical History: Tonsillectomy- as child Cholecystectomy- 15 years ago (51 years old)
Current Medications: “migraine pills” St. John’s wort oil – for skin inflammation to left leg (for a week)
Past History: Smokes ½ a pack of cigarettes per day (since she was a teenager)
Weight: 70 kg
Height: 150 cm
DOCTOR’S ORDER:
Medications:
Ancef 750 mg IV q12h
Elavil 50 mg po
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If headache recurs, doses may be repeated q 2 hr (not to exceed 200mg/day)
Doctor’s Order: 75mg q4H max 2 doses daily
Is this Safe?: NO. The dose should be lesser. 25-50mg for lesser interval of q2H.
Metformin
Safe Dosages: 500mg twice daily. May increase by 500mg at weekly intervals up to
2000mg/day. If doses >2000mg/day are required, give in 3 divided doses (not to exceed 2500mg/day)
Doctor’s Order: 750mg TID with meals
Is this Safe?: YES
Buffered Aspirin (Salicylates)
Safe Dosages: 2.4g/day initially; increased to maintenance dose of 3.6-5.4g/day in divided doses (upto 7.8g/day for acute rheumatic fever)
Doctor’s Order: 650mg (or .65g) q6H PRN
Is this Safe?: NO. The dose 650mg (or .65g) q 6H PRN that was ordered was lesser than what is a safe dose according to the drug guide. And dose wouldn’t be enough to help client’s pain.
3. What would you do if the dosage ordered was not safe?
Clarify the order with the Physician involved. Refer to the drug guide or any reliable source if necessary.
4. Indicate potential drug
Most of the basic information on prescribing practices was available in the report. However, a more in-depth analysis of some of the data was missing. It would have been helpful to see the data analyzed by demographic and geographic variables.
With unrelieved symptoms after first dose, an additional dose may be taken 2 hours from the first dose
MaX VRL (XYM): 2 capsule twice a day for two weeks then 1 capsule twice daily. (gly)
The recommended dose for children in this guideline is (3 mg/kg loading dose followed by maintenance dose of 1.5 mg/kg/day), but because of the small body of evidence supporting the use of anidulafungin; the recommendation level is low (BII). The use of anidulafungin in neonates is not recommended by ESCMID
With access to prescription drugs, people are able to treat a multitude of diseases and illnesses. These drugs help deal with pain, inability to sleep, depression, and much more. Every day we are increasingly living in a world where there is better living through chemicals. However, what most do not seem to see is the rising tide of pain, illness, and ultimately death being caused by the pills people take every day. Most keep drugs in a special place in their minds, where they see them as harmless. Sadly, this is not the case, and in some cases our prescription drugs can be just as harmful as illegal drugs (King 68).
Bryant, B., & Knights, K. (2014). Pharmacology for Health Professionals (4th ed.). Chatswood, NSW: Elsevier Health Sciences.
“The key is to ensure that one is getting the right dose”. It varies from person to person and that’s why typically the medication comes in a variety of strengths such as 25, 50, 75, 88, 100, 112, 125, 137, 150, 200 and 300 mcg. Most people however will need about 100-125 mcg daily. In addition to clinical findings, blood tests are very useful in determining the dose. The goal is to keep the TSH between 0.4 to 2 and free T4 levels on the high normal side.
Some patients may take the supplement start from 3 mg./day before bedtime and see if there are any side effect after take the supplement. In case if the patients take the supplement in certain amount and found that they still fell tired and inactive in the morning, so they should reduce the dosage. In contrary if patients still have the symptoms of being sleepless, they should increase the dose by up to 3 mg./night until the supplement become effective.
A dosage of 2 drops a day for 7 days a week is often prescribed4.
Do not take the medicine if you suffer from any cardiovascular disease, or any heart related diseases. Inform your doctor before consuming this medicine.
drug reference standard is a standardized substance which is used as a measurement base for similar substances. Where the exact active substances of a new drug are not known, a reference standard provides a calibrated level of biological effects against which new preparations of the drug can be compared. drug reference solutions and patient education materials put the best available information into the hands of clinicians and patients. They supply critical information regarding dosage, efficacy, interactivity and allergies, even suggesting alternate therapies as appropriate. Drug reference Standards are highly characterized physical specimens used in testing by pharmaceutical and related industries to help ensure the identity, strength, quality,
Woo, T.M., Wynne, A.L. (2012). Pharmacotherapeutics for Nurse Practitioner Prescribers, 4th ed. F.A. Davis. ISBN 978-0-8036-3827—3 & ISBN
patients follow directions and be aware of potential interactions with other drugs. Don’t just change your dose without discussing with your doctor first. Never use another persons prescription.
Dose reduction for moderate renal impairment CrCl 30-50 ml/min to 220mg/day as 110mg twice daily dosing5,6.
5mg is prescribed for women and 10 mg is prescribed for men before going to bed. Overdosage results in dizziness and restlessness. Normal chores and activities of the next day are deteriorated. Patients suffering from liver disease, kidney disease or mental impairment should limits the dosage to 5 mg. This drug cannot be prescribed without doctor’s approval. One should refrain recommending this drug even if the other person’s is in the same dilemma like you.