Effective Treatment for Mild Pediatric Asthma Attacks- Symptom Management and Recommendations

Effective Treatment for Mild Pediatric Asthma Attacks- Symptom Management and Recommendations

Question One

Noting that mild asthma episodes occur while playing soccer with his friends, it is evident that the 12-year-old boy’s asthma is exercise-induced. Since the symptoms of an asthma attack occur occasionally only during physical activity, the possible treatment to help relieve the symptoms would be albuterol. Albuterol is a short-acting beta-agonist (SABA). Albuterol is FDA-approved for managing and preventing acute to severe symptomatology in patients with reversible obstructive airway conditions, such as exercise-induced asthma (Johnson et al., 2023).

Question Two

If the patient’s asthma attacks occur more frequently, a change of therapy will include increasing the dosage and frequency of administration of the inhaled albuterol combined with other non-pharmacological treatments. The albuterol will need to be administered before any physical activity. The patient also needs to do warm-ups before all physical activity. If these changes are not effective, the patient must be put under maintenance therapy to avoid any complications. For the maintenance therapy, a prescription of an inhaled corticosteroid will be made. In this case, the patient will need to be put under fluticasone as the maintenance therapy.

Question Three

First, the assessment of the 19-year-old student will include her medical history, current sexual activity, blood pressure, sexual health, a pelvic examination, and reasons for asking for contraceptives. If she qualifies, I will prescribe her a non-hormonal (copper) intrauterine device (IUD) sold under the brand ParaGard. The copper UID is only inserted into the uterus once and can remain functional for several years. Non-hormonal copper IUD does not induce any hormonal changes in the body since it is non-hormonal and works by preventing sperm from entering the uterus and the fallopian, hence preventing fertilization of a released egg. The adverse effects of the copper IUD are inflammation of the vagina, painful sex, and anaemia.

Question Four

To help the patient manage her acne, I would prescribe a combination pill with drospirenone, ethinyl estradiol, and levomefolate, majorly sold under the brand name Beyaz. The medication is to be taken as one pill at a dosage of 3 mg-0.02 mg-0.451 mg, taken orally once every 24 hours. The medication must be taken daily with a strict cycle throughout the period the patient does not intend to get pregnant. The reasons for prescribing Beyaz are due to her age. Besides, drospirenone and ethinyl estradiol combination is effective in treating moderate acne vulgaris with a notable effect on the prevention of fertility-threatening conditions such as endometriosis and pelvic inflammatory disease (Rapisarda et al., 2019). This means it not only manages teenage and young adult acne in women but also preserves fertility.

Question Five

Bisphosphonates are used to prevent and treat osteoporosis and eventual bone fractures by slowing the natural processes associated with bone dissolution and bone resorption. Bisphosphonates also reduce the risks of bone fractures by supporting the development of bone tissue, resulting in thicker and stronger bones. To be most effective, the patient is expected to take the medication on an empty stomach with plenty of water.

Question Six

I would treat this patient’s acute gout attack and the associated pain and swelling with nonsteroidal anti-inflammatory drugs (NSAIDs). I would specifically prescribe indomethacin, sold mainly under Indocin and Tivorbex. The medication is to be taken at 25mg orally three times daily. According to Sobhani et al. (2023), indomethacin as an NSAID works by inhibiting the production of the enzyme cyclooxygenase (COX), which is essential in the conversion of arachidonic acid into thromboxanes, prostaglandins, and prostacyclins hence reducing inflammation and pain.

References

Johnson, D. B., Merrell, B. J., & Bounds, C. G. (2023). Albuterol. Encyclopedia of Toxicology: Third Edition, 112–115. https://doi.org/10.1016/B978-0-12-386454-3.00809-5

Rapisarda, A. M. C., Brescia, R., Sapia, F., Valenti, G., Sarpietro, G., Di Gregorio, L. M., Della Gatta, A. N., La Rosa, V. L., Sergiampietri, C., Della Corte, L., & Monaco, C. (2019). Combined oral contraceptive in adolescent and young adult women: Current evidence and future Perspectives. Current Women’s Health Reviews, 15(2), 109–118. https://doi.org/10.2174/1573404814666180914162053

Sobhani, K., Li, J., & Cortes, M. (2023). Nonsteroidal anti-inflammatory drugs (NSAIDs). First Aid Perioperative Ultrasound: Acute Pain Manual for Surgical Procedures, 127–138. https://doi.org/10.1007/978-3-031-21291-8_8

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WEEK 7 – PHARMACOLOGY DISCUSSION
Discussion Prompt
Post your answers to the 6 questions corresponding to this week’s content on primary care medication management. Provide your responses and rationales. Support your rationales with high-level evidence. (See Post Expectations)

A 12-year-old boy has occasional episodes of mild asthma while playing soccer with his friends.
• Q1. What treatment should this patient receive to relieve symptoms during an asthma attack?
• Q2. If the patient’s asthma attacks occur more frequently, what changes in therapy might be appropriate?
A 19-year-old college student is asking for contraceptives.
• Q3. What will you assess to determine if this patient is a good candidate for contraceptives, and what will you prescribe? (Include brand and generic name, route, frequency, and dose). What is the mechanism of action of the contraceptive you prescribed and the adverse effects?
• Q4. The patient states she heard a pill can help her acne. What would you prescribe and what is your rationale? (Include brand and generic name, dose, route, and frequency).
• Q5. The patient is concerned because her mother and sister developed fractures in their legs and vertebrae after menopause. She wants to know what medication and other advice will prevent osteoporosis. You discuss bisphosphonates. How are they used in the prevention and treatment of osteoporosis?
A 48-year-old man has occasional episodes of gout that are painful and debilitating. He requires drugs to treat the symptoms of acute gout attacks and prevent recurrent attacks.
• Q6. How would you treat this patient’s acute gout attack? Please list the trade and generic name and the dose of therapy. What is the mechanism of action of your choice of prescription?