Comprehensive Management Considerations for Asthma Chronic Pain Birth Control and Weight Loss in a 26-Year-Old Female
Thank you for your post. Perhaps the patient should continue with her current contraceptive. The patient is struggling with weight issues and would like to lose weight. Prescribing Ethinyl oestradiol and norethindrone is not recommend for persons with excessive weight (Jusko, 2017). Using this medicine can increase the patient’s risk of a heart attack, stroke, or blood clots. The patient is even more at risk because she is overweight, especially if she has pre-existing high cholesterol, diabetes, or high blood pressure, and is unaware of the same. In addition, the patient has had asthma for several years, which makes this choice of contraceptive not the best option.
Acupuncture, as you have stated, is a good option for the patient’s chronic knee pain. According to the National Institute of Health (NIH) (n.d), several studies suggest that acupuncture is effective, especially in chronic pain such as neck or back pain, headache, knee pain, and osteoarthritis of the knee. Acupuncture often reduces the severity and incidences of tension headaches and can even prevent migraines. The NIH concludes that acupuncture is a reasonable option for persons who suffer from chronic pain. Pain relief that comes from acupuncture comes from inactivating the pain source by modulating the level of endorphins. Diet and exercise will be beneficial for her weight loss and help her manage her symptoms of asthma. A healthful, balanced diet rich in vegetables and fruit can help reduce the development of asthma. Vegetables and fruits are also rich in antioxidants such as beta carotene, vitamin E, and vitamin C, which help the body fight toxins that damage the body’s tissues.
References
Jusko, W. J. (2017). Clarification of contraceptive drug pharmacokinetics in obesity. Contraception, 95(1), 10-16.
National Institute of Health (n.d). Acupuncture: In Depth. https://www.nccih.nih.gov/health/acupuncture-in-depth
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Question 
CASE STUDY:
Ms. Whitley is a 26 year old female. She has had a history of asthma since grade school; for the last 3 months, she has had to use her Albuterol inhaler 3-4 times per week, sometimes at night. She states she has chronic knee pain from playing soccer in high school, has no surgeries, and takes Acetaminophen as needed. She also asks about starting a birth control method, currently using condoms. She asks what you think about medication to help with weight loss since she would like to drop the 20 lbs she gained in college.
Comprehensive Management Considerations for Asthma Chronic Pain Birth Control and Weight Loss in a 26-Year-Old Female
What medication recommendations will you make? Include the drug class, generic and trade name, and starting dose range. Provide a rationale for your choices.
Discuss any potential side effects and drug interactions for this patient.
What non-pharmacological interventions would you suggest?
What patient education would you provide?
What medication recommendations will you make? Include the drug class, generic and trade name, and starting dose range. Provide a rationale for your choices.
Ms. Whitley’s asthma is not well controlled. Therefore, the medication recommendation I would make is to add an inhaled glucocorticoid, such as Budesonide (Pulmicort Flexhaler), 360-720 mcg, twice daily (Rosenthal & Burchum, 2021, p. 562). This medication is an anti-inflammatory drug, which is the foundation of asthma therapy. Budesonide should be administered regularly, not as needed, for preventive therapy and long-term control of airway inflammation (Rosenthal & Burchum, 2021). The Albuterol inhaler, an inhaled short-acting beta-agonist (SABA), effectively relieves acute bronchospasms and should be administered as needed to abort an ongoing attack (Rosenthal & Burchum, 2021, p.568).