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Evaluation of Drug Treatment Plans for Patients with Various Disorders

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Evaluation of Drug Treatment Plans for Patients with Various Disorders

Managing patients with diverse medical conditions requires a tailored approach to medication selection, patient education, and monitoring. The following scenarios highlight individualized treatment plans for various disorders supported by clinical guidelines and patient-specific considerations.

Scenario 1: Urinary Tract Infection (UTI) in Pregnancy

RT, a 34-year-old pregnant woman at 20 weeks gestation, presents with painful urination, increased urgency, and fatigue. A urine dipstick test confirms a UTI, but the initial prescription of doxycycline is inappropriate due to its teratogenic risks (Maina et al. 2023). In pregnancy, antibiotics with proven safety profiles are essential to avoid harm to the fetus: Evaluation of Drug Treatment Plans for Patients with Various Disorders.

Prescription

Cephalexin 500 mg orally every 12 hours for 7 days is recommended as it is effective and safe during pregnancy. RT should be instructed to take the medication with water and complete the full course to prevent recurrence or complications. A total of 14 tablets will be dispensed with no refills (Herman & Hashmi, 2023). Since pregnancy causes an increase in blood plasma volume, the concentration of drugs may be reduced and, therefore, require a dosage change (Pinheiro & Stika, 2020).

Teaching involves keeping well hydrated, compliance with a treatment plan, and knowing signs such as persistent pain or fever, which call for a follow-up (Song et al., 2023). Supervision includes a further urine culture after the completion of antibiotics to ensure the problem is over (Childers et al., 2022).

Scenario 2: Vulvovaginal Candidiasis (VVC)

GP, a 21-year-old sexually active female, presents with thick, white, odorless vaginal discharge and itching. Her symptoms are consistent with vulvovaginal candidiasis. Given her sulfa allergy, fluconazole is an effective and appropriate treatment option (Satora et al. 2023).

Prescription

Fluconazole 150 mg as a single oral dose is prescribed for GP. She should avoid alcohol during treatment to minimize adverse effects. A single tablet will be dispensed with no refills (Jeanmonod & Jeanmonod, 2019). Patient education should include refraining from sexual activities for one week or until symptoms have cleared up to reduce reinfection or transmission.

It would be important to orient GP to future precautions that include regular use of condoms. As mentioned, GP should also be reminded about the side effects of fluconazole regarding sedation when this drug is taken together with alprazolam (Govindarajan et al., 2020). Notably, prolonged drowsiness should be reported to the doctor, and the woman must not drive or operate any machinery in case of such symptoms.

Scenario 3: COVID-19 Management

LW, a 66-year-old male, presents with mild COVID-19 symptoms, including fatigue, brain fog, and a mild fever. With no signs of pneumonia and stable vital signs, symptomatic management is the appropriate course of action.

Prescription

Acetaminophen 500 mg orally every 6 hours as needed for fever and discomfort is recommended, with a maximum daily dose of 3,000 mg. A total of 20 tablets will be dispensed with no refills (Gerriets & Nappe, 2024). LW should be educated on self-isolation to prevent transmission, maintaining adequate hydration, and resting to support recovery.

He should monitor for worsening symptoms, such as difficulty breathing, and seek immediate medical attention if they occur (Liu & Liu, 2020). Avoiding alcohol during treatment is critical to reducing the risk of acetaminophen-induced hepatotoxicity, especially in older adults. Regular follow-ups via telehealth can help track his progress.

Scenario 4: Polycystic Ovary Syndrome (PCOS) and Iron Deficiency Anemia

FS, a 35-year-old female with PCOS, presents with laboratory evidence of iron deficiency anemia. Metformin is part of her current regimen to manage PCOS by improving insulin sensitivity. To address anemia, iron supplementation is indicated.

Prescription

Ferrous sulfate 325 mg orally once daily is prescribed. FS should take the medication with vitamin C to enhance absorption and avoid taking it alongside dairy products to prevent interference with absorption. A 30-day supply will be dispensed with one refill (Nguyen and Tadi, 2023).

Education includes emphasizing an iron-rich diet with foods like leafy greens, beans, and lean meats. FS should also be informed about managing common side effects of iron supplementation, such as constipation, by increasing fiber intake and staying hydrated (Dalal Al-Akabi & Hanadi Hafth, 2023). Monitoring includes reassessing her hemoglobin and ferritin levels after 4-6 weeks to evaluate the treatment’s efficacy.

Conclusion

The outcomes described in the scenarios above make us understand why different patients need to be treated individually whenever they are pregnant, have an allergy to a particular medication, have other diseases and when drug interactions are present. Both plans incorporate knowledge of prescriptions, education of the patient and strict supervision to guarantee safe and effective results. By achieving all these it means that health facilities, doctors, nurses and all other caregivers will have compacted care hence enhancing the health of their patients irrespective of the-ended presentation.

References

Childers, R., Liotta, B., Brennan, J., Wang, P., Kattoula, J., Tran, T., Montilla-Guedez, H., Castillo, E. M., & Vilke, G. (2022). Urine testing is associated with inappropriate antibiotic use and increased length of stay in emergency department patients. Heliyon, 8(10), e11049. https://doi.org/10.1016/j.heliyon.2022.e11049

Dalal Al-Akabi, & Hanadi Hafth. (2023). Physiological effect of iron status on patients with polycystic ovary syndrome in Basrah city. Journal of Medical Biochemistry, 42(3), 530–535. https://doi.org/10.5937/jomb0-39091a

Gerriets, V., & Nappe, T. M. (2024, January 11). Acetaminophen. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482369/

Govindarajan, A., Bistas, K. G., & Aboeed, A. (2020). Fluconazole. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537158/

Herman, T. F., & Hashmi, M. F. (2023, August 17). Cephalexin. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK549780/

Jeanmonod, R., & Jeanmonod, D. (2019). Vaginal Candidiasis (Vulvovaginal Candidiasis). National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459317/

Liu, J., & Liu, S. (2020). The management of coronavirus disease 2019 (COVID‐19). Journal of Medical Virology, 92(9). https://doi.org/10.1002/jmv.25965

Maina, J., Mwaniki, J., Mwiti, F., Kiiru, S., Katana, J., Wanja, F., Mukaya, J., Osborn Khasabuli, Benon Asiimwe, Gillespie, S., Stelling, J., Mshana, S., Holden, M., Sabiiti, W., & Kiiru, J. (2023). Evaluation of the diagnostic performance of the urine dipstick test for the detection of urinary tract infections in patients treated in Kenyan hospitals. Access Microbiology, 5(6). https://doi.org/10.1099/acmi.0.000483.v3

Nguyen, M., & Tadi, P. (2023, July 3). Iron supplementation. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557376/

Pinheiro, E. A., & Stika, C. S. (2020). Drugs in pregnancy: Pharmacologic and physiologic changes that affect clinical care. Seminars in Perinatology, 44(3), 151221. https://doi.org/10.1016/j.semperi.2020.151221

Satora, M., Grunwald, A., Zaremba, B., Frankowska, K., Żak, K., Tarkowski, R., & Kułak, K. (2023). Treatment of Vulvovaginal Candidiasis—An Overview of Guidelines and the Latest Treatment Methods. Journal of Clinical Medicine, 12(16), 5376. https://doi.org/10.3390/jcm12165376

Song, Y., Zhang, F., Lin, G., Wang, X., He, L., Li, Y., Zhai, Y., Zhang, N., & Ma, G. (2023). A Study of the Fluid Intake, Hydration Status, and Health Effects among Pregnant Women in Their Second Trimester in China: A Cross-Sectional Study. Nutrients, 15(7), 1739. https://doi.org/10.3390/nu15071739

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Question

Case Studies

For your week 9 assignment, evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.

To Prepare:

  • Review assignment rubric and case studies. Be sure to thoroughly answer ALL
  • 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 to support each scenario and cite them in APA format. Please include in-text citations. You do not need an introduction or conclusion paragraph.

Cases
SCENARIO 1

  • RT is a 34-year-old pregnant female at 20 weeks gestation. She presents to the clinic with painful urination, increased urge to urinate, and fatigue. A urine dipstick test is positive for a UTI and she is started on doxycycline 100 mg po BID x 7 days. Current medications include labetalol 100 mg po BID, fluoxetine 20 mg po daily, and valacyclovir 500 mg po daily.
    She has no drug allergies. Labs include Hgb 12.5, HCT 37%, K 3.9, glucose 78, BUN 9, Cr 0.7 Her blood pressure is 130/75 mmHg. What treatment plan would you implement for RT (include complete medication order)? What patient education would you provide and how would you monitor drug therapy? Do pregnant patients have increased or decreased blood plasma volume?

    Evaluation of Drug Treatment Plans for Patients with Various Disorders

    Evaluation of Drug Treatment Plans for Patients with Various Disorders

SCENARIO 2

  • GP is a 21-year-old female presenting with thick white, odorless vaginal discharge and itching for 3 days. She is sexually active and has had unprotected sex with a new male partner for the last month. Current medications include ethinyl estradiol/norgestrel 30 mcg/0.3 mg po daily and alprazolam 2 mg po TID prn. This patient is allergic to sulfa drugs.
    What medication would you prescribe for this patient (include complete medication order)? How long should GP abstain from sexual activity? What patient education would you provide? What possible drug interactions exist?

SCENARIO 3

  • LW is a 66-year-old male seen in the clinic today. He presents with extreme fatigue, brain fog, minor sore throat and temperature of 100.8. He reports that symptoms began two days ago with a sore throat and have progressively worsened. He also mentions loss of appetite. Oxygen sat 96%, respiratory rate 18, bp 130/80.
    His rapid COVID-19 antigen test is positive. Chest x-ray is clear, no signs of pneumonia. What treatment plan would you implement for LW (include complete medication order)? What education would you provide? Discuss one potential drug interaction and how you would manage it.

SCENARIO 4

  • FS is a 35-year-old female trying to conceive with a medical history of PCOS. Her labs today show a MCV 77, MCHC 26, Ferritin 9, TIBC 415, BG 90 mg/dL, A1C 5% Current medications include metformin 500 mg po BID and a B vitamin complex. What treatment plan would you implement for FS?
    Why is this patient on metformin? How would you monitor this patient’s response to the medication? What patient education would you provide?
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