To Prepare:
· Be sure to thoroughly answer ALL questions.
· Explain the problem and discuss how you would address the problem.
· When recommending medications, write out a complete prescription for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, special instructions, # dispensed (days supply), refills, etc. Also state if you would continue, discontinue or taper the patient’s current medications.
· Answer questions using your required learning resources, clinical practice guidelines, Medscape and JNC 8.
· Include at least three references (WITHIN PAST FIVE YEARS) to support each scenario and cite them in APA format. Please include in-text citations. You do not need an introduction or conclusion paragraph.
WEEK 7 ASSIGNMENT-do all FOUR SCENARIOS
SCENARIO 1
Sandra is a 52-year-old female with past medical history of hypertension and GERD. Current medications include pantoprazole 40 mg po daily 30 minutes before breakfast and HCTZ 50 mg daily. She smokes 1 pack per day and presents with persistent sadness, anxiety and “empty mood.” Her smoking habit has increased the past month as she says it “helps calm her nerves.” She denies any history of seizures. How would you treat Sandra? What medication would you prescribe (include complete medication order)? What education would you provide to the patient? What labs would you order?
SCENARIO 2
Patient JR is experiencing symptoms of pain, numbness and tingling in his legs. He states he sometimes has trouble keeping his balance and feels easily fatigued. He is currently on metformin 1000 mg po BID, Synjardy XR 5/1000mg po daily, Tresiba 20 units SC daily and rosuvastatin 10 mg po daily. What is your working diagnosis? How would you treat JR and improve his treatment? What would you monitor?
SCENARIO 3
Zolpidem has a half-life of 3 hours. If a patient takes 10 mg at 10 pm, what will the blood level be at 7 am? Do elderly patients need a smaller dosage of zolpidem? Name 3 antidepressants/antipsychotics you might prescribe for patients with co-existing depression and insomnia (include complete medication orders) and include patient monitoring.
SCENARIO 4
A mother brings her 7-year-old son David into the clinic today stating that he is increasingly getting into trouble at school. He “fidgets and frequently leaves his seat, does not listen to his teacher, talks excessively and interrupts other classmates.” What would you prescribe for David? How common is it for a parent and child to both have ADHD? How are symptoms and treatment of ADHD different between children and adults? What would you prescribe for David’s 40-year-old mother with ADHD?
