Pharmaceutical Treatment Regimens

12-year-old with new onset asthma

A twelve-year-old who has moderate to severe persistent asthma should use a combination of ‘inhaled corticosteroid and long-acting beta-agonist (ICS/LABA)’ to reduce inflammation and keep the airway open. Fluticasone propionate 110 mcg/salmeterol 50 mcg delivered by dry powder inhaler, used twice daily, is a suitable regimen. To help treat wheezing or shortness of breath, the patient should use albuterol sulfate two puffs at 4 to 6 hours intervals as needed: Pharmaceutical Treatment Regimens.

A non-prescription saline spray may prevent exposure to environmental allergens and manage upper airway hygiene. This treatment manages chronic inflammation in the airway and provides help for acute symptoms. With knowledge from pediatrics, respiration, physiology, and health education, it is possible to protect children and help them stick to the prescribed action plan for asthma (Chu & Bajaj, 2024).

45-year-old with community acquired pneumonia- outpatient managed

In a healthy patient aged forty-five with CAP being treated as an outpatient, empiric therapy for typical and atypical causes is advised. Recommended Prescription is amoxicillin-clavulanate 875/125 milligrams taken orally twice daily for seven days and azithromycin 500 milligrams orally on the first day, then 250 milligrams daily for the following four days. The combination works on Streptococcus pneumoniae and atypical organisms, including Mycoplasma pneumoniae. Albuterol sulfate 90 mcg delivered by metered dose inhaler (a short-acting beta agonist) should be prescribed two puffs every 4–6 hours as needed for wheezing or shortness of breath.

For supportive care, patients should still be given acetaminophen 500 milligrams every 6 hours to control fever and discomfort. Azithromycin is a macrolide antibiotic, amoxicillin-clavulanate is a beta-lactam/beta-lactamase inhibitor, and albuterol is in the drug class of short-acting beta-agonists.  To manage CAP effectively, staff should understand microbiology and pharmacokinetics and be able to educate patients on finishing their antibiotic course and what to do if symptoms become more severe (Regunath & Oba, 2024).

72-year-old with chronic stable COPD

For a 72-year-old with chronic stable COPD and a history of exacerbations, dual maintenance therapy is appropriate. A daily inhaled long-acting muscarinic antagonist such as tiotropium 18 micrograms via HandiHaler, one capsule inhaled once daily, improves airflow and reduces exacerbations. In addition, a combination LABA/ICS inhaler such as salmeterol 50 micrograms or fluticasone 250 micrograms, one inhalation twice daily, provides added bronchodilation and anti-inflammatory benefits.

Non-pharmacological interventions such as pulmonary rehabilitation should be encouraged to improve functional capacity and quality of life. Managing COPD in older adults necessitates a multidisciplinary approach, including geriatric pharmacology, respiratory therapy, and patient education to ensure appropriate inhaler technique and adherence to long-term treatment (Agarwal et al., 2023).

References

Agarwal, A. K., Raja, A., & Brown, B. D. (2023, August 7). Chronic obstructive pulmonary disease. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559281/

Chu, R., & Bajaj, P. (2024, January 11). Asthma medication in children. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK441823/

Regunath, H., & Oba, Y. (2024, January 26). Community-Acquired pneumonia. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK430749/

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Create a pharmaceutical treatment regimen for each of the following.

• 12-year-old with new onset asthma. Moderate- severe: persistent
• 45-year-old with community acquired pneumonia- outpatient managed
• 72-year-old with chronic stable COPD.

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