Week 7 Pharm – Recommended Drugs and Side Effects
The Albuterol inhaler has not been effective in managing the patient’s symptoms. She has been using this drug 3-4 times a week over the last three months. This drug is a rescue inhaler that should not be used more than two times a week to manage asthma symptoms (Israel & Reddel, 2017). There is thus a need to change the patient’s drug, The drug that the patient will be started on is Beclomethasone diproprionante inhaler at 100mcg BD. The most common brand name is Qvar RediHaler. It is an inhaled corticosteroid used in the management of asthma (Tillinghast et al., 2018). Some side effects include oropharyngeal candidiasis, dysphonia, and adrenal suppression (Tillinghast et al., 2018). The drug interactions that the patient should look out for include interactions with BCG live vaccine and tacrolimus ointment.
For the patient’s knee pain, I will give her Tramadol 100 mg BD. This is a narcotic analgesic effective in managing long-term pain (Subedi et al., 2019). The acetaminophen seems not to be working; hence a switch to a more potent will benefit this patient. Some of the brand names include ConZip, Rybix ODT, and Ultram. Some of the common side effects of this drug include sedation, constipation, respiratory depression, headache, hepatotoxicity, and kidney injury (Subedi et al., 2019). The drug interactions associated with Tramadol include alcohol, which intensifies CNS depression, and benzodiazepines.
The patient also inquired about birth control methods. This patient will be started on a combined oral contraceptive containing estrogen and progesterone derivatives. Seasonique contains levonogesterol and Ethinyl estradiol. It works by preventing ovulation, thickening vaginal fluids, and changing uterine wall lining (Burness, 2015). It is taken once daily. Some common side effects include nausea, vomiting, bloating, and vaginal bleeding (Burness, 2015). The common drug interactions include tizanidine, rifabutin, and ospemifene.
Non-pharmacological Interventions
Drugs should not be used as the first line in weight. The patient will be advised to implement lifestyle modifications to help her in weight loss. She will be advised to start being physically active and to do moderate and intense activities. The activities include jogging and back riding. She will also implement dietary modifications by reducing meals containing carbohydrates and saturated fats. She will be advised to implement a ketogenic diet. Her diet will include low-calorie foods, vegetables, fruit, and water (Rock, 2016). She will also be advised to try non-pharmacological methods of controlling her pain. These can include meditation, relaxation techniques, and yoga. (El Geziry et al., 2018). This can be augmented with tramadol.
Patient Education
It will be critical to educate the patient on the benefits of medication compliance. She should be told of the negative effects of missing her beclomethasone inhaler and contraceptive medications. She should take her contraceptive every day before bedtime since this drug can cause stomach upsets (Burness, 2015). If she forgets her drug, she should take the pill immediately she remembers and use a barrier method such as a condom (Barnett et al., 2017). The patient will be advised to use a spacer with her inhaler since this can help minimize the incidences of oropharyngeal candidiasis (Tillinghast et al., 2018). Finally, she should be warned of the dangers of taking alcohol with her drugs, such as tramadol, since this can result in sedation.
References
Barnett, C., Hagemann, C., Dinger, J., Do Minh, T., & Heinemann, K. (2017). Fertility and combined oral contraceptives–unintended pregnancies and planned pregnancies following oral contraceptive use–results from the INAS-SCORE study. The European Journal of Contraception & Reproductive Health Care, 22(1), 17-23
Burness, C. B. (2015). Extended-Cycle Levonorgestrel/Ethinylestradiol and Low-Dose Ethinylestradiol (Seasonique®): A Review of Its Use as an Oral Contraceptive. Drugs, 75(9), 1019-1026.
El Geziry, A., Toble, Y., Al Kadhi, F., & Pervaiz and Mohammad Al Nobani, M. (2018). Non-pharmacological pain management. Pain Management in Special Circumstances. https://doi.org/10.5772/intechopen.79689
Israel, E., & Reddel, H. K. (2017). Severe and difficult-to-treat asthma in adults. New England Journal of Medicine, 377(10), 965-976
Rock, C. L., Flatt, S. W., Pakiz, B., Barkai, H. S., Heath, D. D., & Krumhar, K. C. (2016). Randomized clinical trial of portion‐controlled prepackaged foods to promote weight loss. Obesity, 24(6), 1230-1237
Subedi, M., Bajaj, S., Kumar, M. S., & YC, M. (2019). An overview of tramadol and its usage in pain management and future perspective. Biomedicine & Pharmacotherapy, 111, 443-451. https://doi.org/10.1016/j.biopha.2018.12.085
Tillinghast, J. P., LaForce, C. F., Hickey, L., & Small, C. J. (2018). Patient-reported outcomes and quality of life improvements in patients with asthma receiving a new, breath-actuated Beclomethasone Dipropionate inhaler. Journal of Allergy and Clinical Immunology, 141(2), AB62. https://doi.org/10.1016/j.jaci.2017.12.198
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Question 
Week 7 pharm-Recommended Drugs and Side Effects
Discussion Prompt
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, 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.
Week 7 pharm-Recommended Drugs and Side Effects
- 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?
Expectations
Initial Post:
Length: A minimum of 500 words, not including references
Citations: At least two high-level scholarly references in APA from within the last 5 years