Seasonal Allergies – Medication Recommendation Request (Eric Johnson)

Seasonal Allergies – Medication Recommendation Request (Eric Johnson)

The Recommended Medications to Start This Specific Patient on

For pneumonia, the recommended antibiotics would be azithromycin, a macrolide, or doxycycline, a tetracycline. Considering the patient’s age and presentation, azithromycin (Zithromax) 500 mg orally once daily for five days is suitable (Katzung et al., 2021). For chlamydia, a first-line treatment is azithromycin as well. The recommended dose for chlamydial infections is usually a single 1-gram oral dose. An antihistamine like loratadine (Claritin) 10 mg orally once daily can be prescribed for symptomatic relief of allergies.

The Mechanism of Action of Each of the Listed Drugs

Azithromycin (Macrolide Antibiotic)

Specifically, it binds with the 50S ribosomal unit in susceptible bacteria, whereby it hinders peptide bond formation and protein synthesis (Katzung et al., 2021).

Doxycycline (Tetracycline Antibiotic)

It binds on the 30S ribosomal subunit, blocking the attachment of amino acids to the peptide chain.

Loratadine (Antihistamine)

It is a specific peripheral histamine H1 receptor blocker. It helps alleviate the adverse effects of histamine – a naturally occurring substance in the body that triggers allergic symptoms such as sneezing, itching, weeping eyes, and running nose.

The Side Effect Profile of each Listed Medication

Azithromycin

Common side effects include abdominal pain, nausea, diarrhea, and vomiting. Serious but rare side effects may include arrhythmias.

Doxycycline

Common side effects include gastrointestinal upset, photosensitivity, and the risk of esophageal irritation. Rare but serious side effects include hepatotoxicity and photosensitivity (Katzung et al., 2021).

Loratadine

Common side effects are headache, dry mouth, fatigue, and gastrointestinal disturbances. Loratadine is generally well-tolerated.

Interactions Between any of the Prescribed Medications

Azithromycin and doxycycline have no significant drug interactions with loratadine (Katzung et al., 2021). However, it is essential to review the patient’s complete medication history to identify any potential interactions with other medications he may be taking.

Other Non-Pharmacological Interventions

Non-pharmacological pneumonia and seasonal allergies interventions include adequate rest, hydration, and good respiratory hygiene (American Lung Association, 2023). For chlamydia, the patient should be counseled on safe sex practices and the importance of informing recent sexual partners for testing and treatment. The patient should also be taught about the need to finish administering all the drugs for the period prescribed and attend the subsequent visit.

References

American Lung Association. (2023). Pneumonia treatment and recovery. Www.lung.org. https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia/treatment-and-recovery#

Katzung, B. G., Kruidering-Hall, M., Tuan, R. L., Vanderah, T. W., & Trevor, A. J. (2021). Katzung & Trevor’s pharmacology examination and board review (13th ed.). McGraw Hill Professional.

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Post your answers to the 5 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)

Eric Johnson is a 21-year-old Caucasian male in his senior year of college. The patient has a history of seasonal allergies. He does not remember what his allergist told him to take for his allergies in the past. He wants to know what he can take. He presents to the clinic today with complaints of a stuffy nose, shortness of breath, a fever of TMAX 102 at home, and a productive cough. He also notes that over the past few months, he has also noticed a watery discharge and burning when he urinates. He does admit to having unprotected intercourse last month. He undergoes rapid testing and a chest x-ray while in the clinic. His diagnoses are pneumonia, chlamydia, and seasonal allergies.

Clinic Vital Signs: BP 125/75, HR 116, Temp 102.5, O2 94%. He has no known drug allergies.

Q1. What are the recommended medications to start this specific patient on? Please provide the drug class, generic & trade name, and the initial starting dose.
Q2. Please discuss the mechanism of action of each of the drugs you listed.
Q3. Please discuss the side effect profile of each medication you listed.
Q4. Are there any interactions between any of the medications you prescribed?
Q5. What other non-pharmacological interventions would be suggested?