Pharmacological Medications - Assignment Example

PHARMACOLOGY: ASSIGNMENT TWO Name: Institution: PHARMACOLOGY ASSIGNMENT TWO Blood and Haemopoietic System 1. Atorvastatin is one of the cholesterol lowering medications and the patient should be made aware of side effects such as diarrhea, nausea, aching muscles, and fatigue associated with the medication. In addition, the patient must also know that the postural hypotension may occur as a side effect and therefore should watch out for signs such as dizziness or blacking out as well as change positions as a preventive measure (Born 2005). The patient must also know that she should not take erythromycins together with this drug, because erythromycins inhibits the metabolism of cholesterol lowering drugs such as Lipitor (Born 2005). 2. Abdominal pain and orange-red urine and saliva could be included as some of the adverse side effects because Cholestyramine is classified as a bile-acid binding resin, which could account for the change in the urine colouration while abdominal pain could be attributed possible indigestion and accumulation of acids in the digestive system (Shroff, 2004). 3. The complaints presented by the patient including complaints of being flushed and hot flushes can be attributed to a rapid increase in prostaglandin activity as well as elevation of uric acid levels which worsen glucose control (Arcangelo & Peterson, 2006). As such, Niacin requires sustained-release formulations rather than immediate release to minimize such adverse side effects (Arcangelo & Peterson, 2006). The response to the patient’s complaints would be administrated with aspirin dose of 325g to decrease the severity of the drugs side effects (Arcangelo & Peterson, 2006). 4. The desired therapeutic effects of clopidogrel (Plavix)in the patient who had experienced transient ischemic attack (TIA)would be to reduce the risk of a stroke from a blood clot. This is because the mechanism of action of the drug entails prevention platelet aggregation by inhibiting the P2Y12 component of ADP receptors thus reducing expression of GP 11b receptors on the platelet cell surface (Griffin, Kapadia & Rimmerman, 2012). 5. Temperature elevation in the patient taking the medication would be attributed to the medication because its use has been associated with significant fever among other common side effects such as vomiting, nausea, and hypotension (Aschenbrenner & Venable, 2009). However, bleeding is reported as the most occurring adverse effects and one, which threatens the survival of the patient especially when experienced in the intracranial regions. Gastrointestinal System 6. Omeprazole (Prilosec) is used as a long-acting acid suppression in response to NSAID-induced ulcers. The drug is an anti-ulcer remedy, which inhibits the H+/K+ proton pump thus reducing the gastric acid secretion, which contributes to the development of stomach ulcers (Arcangelo & Peterson, 2006). On the other hand, clarithromycin (Baiaxin) is prescribed as antibacterial agent to alleviate Helicobacter pylori, a bacterium associated with development of stomach ulcers (Arcangelo & Peterson, 2006). Lastly, amoxicillin (Amoxil) is also an antibacterial agent is required to synergize clarithromycin in order to kill susceptible bacteria in the stomach, which could account for the pain the patient’s stomach. 7. The plan should include timing of the drug administration in which the patient should take the medication before experiencing nausea and as such, the drug is able to prevent nausea and vomiting. In addition, the plan must include adverse side effects symptoms and signs that the patient must watch out for during its use such as drowsiness and dizziness, which depict CNS depression, and hypotension signs. In this case the patient must alert the physician or nurse for appropriate action against the drug’s adverse effects which may undermine the expected patient outcomes. Respiratory System 8. Phenylephrine therapeutic effects include creation of blood pressure stability, and treatment of hypotension associated with septic shock. The drug counters hypotension as a symptom associated with allergic rhinitis (Griffin, Rimmerman & Topol, 2006). Some of the adverse effects that must be monitored include hypertension, bradycardia and symptoms of myocardial ischemia. 9. A patient with a history of intolerance to albuterol (proventil, Vospire) should not be administered with the short-acting bronchodilator, Ipratropium bromide (Atrovent) because the drug is usually as MDI (Dozor & Kelly, 2008). In this case, the drug is combined with albuterol and this may result into severely adverse effects among patients with albuterol. In addition, Atrovent contain soy lecithin, which is chemically related to soy and peanuts and as such, children known to have severe reactions to soy or peanuts should not be administered with the drug (Dozor & Kelly, 2008). 10. The reason for failure by zafirlukast to achieve its desired therapeutic effects can attributed to failure by the patient to take the medication as prescribed or directed. Zafirlukast require strict adherence to the prescription provided by the physician in order to achieve the desired therapeutic effects in the body of the patient. As such, it is highly likely that the client either skipped medication or failed to follow the right prescription in terms of dosage and consistence. 11. The use of the metered-dose inhaler (MDI) education requires significant emphasis on the need to shake the inhaler upon assembling and before use. This step is critical for two reasons including the need to have consistent dosing before the patient proceeds to inhale the medication (Woodrow, Colbert & Smith, 2010). In addition, shaking the inhaler for 10 seconds should be emphasized as a way of discharging waste dose if the inhaler has not been used for at least 24 hours (Woodrow, Colbert & Smith, 2010). Another area of emphasis in education of the patient should be on how to push down the inhaler while breathing slowly and deeply in order to ensure effective and efficient delivery of the medication for maximum efficacy. Anti-inflammatory drugs and analgesics 12. Acetaminophen would be contraindicated or used cautiously for the patient with a history of hypertension. Although the drug could have a high efficacy as a therapy for rheumatoid arthritis, it has been shown to increase high blood pressure. As such, it would be in appropriate for the patient with an history of hypertension. Naproxen (Aleve), should be cautiously used in patients with hypertension because it could lead to new or re-emergence of the condition. The drug is classified under NSAIDs class of drugs, which may worsen pre-existing hypertension, and thus alternative painkillers should be used. 13. A patients should contact their doctor if the experience difficulty in breathing. This is because the patient should not strain. This is important in ensuring that doctor adjusts the medication to achieve the desired efficacy and therapeutic effect. In addition, patients should look out for symptoms such as nausea, flu-like symptoms and headache because they interfere with the distribution of medication and eventually its efficacy. 14. Immediate response is necessary if the patient shows signs such as low respiratory rate such as 10 breaths per minute, the patient becomes unresponsive, and the patient becomes drowsy. The use morphine sulphate could result into respiratory depression, an adverse effect associated with the reduced respiratory rate of 10 breaths per minute, the patient may also become drowsy following and unresponsive following the sedation effect of the drug. Therefore, if a patient presents such signs the doctor should respond immediately by terminating administration of the drug or reduction of the dosage. 15. The 58-year old patient should consult a qualified medic or physician to investigate the potential effects of taking beta-blockers together with aspirin. This is because the interaction between the two medications has been reported to have a counteracting result, which could translate into adverse effects or reduced efficacy of the beta- blockers (Chan, 1995). Aspirin has a counteractive effect on the blood pressure reducing beta-blockers by counteracting the effects of prostaglandins. As such, it is recommended that a physician should closely monitor the patient to ensure identification of unwanted medication reactions (Chan, 1995). In addition, the combination of anticoagulant medications with aspirin could result into excessive bleeding and as such, the patient should be under a close watch by a physician or nurse. The Endocrine System 16. A doctor would be forced to withhold the patient’s regularly scheduled dose of levothyroxine when the patient’s heart rate is found to be 110 beats/minute. This is because main the adverse side effect of levothyroxine is hyperthyroidism in which excessive thyroid hormones make the heart to work extra harder and faster to meet the increase tissue demand for oxygenated blood and nutrition (Frandsen & Pennington, 2013). In this case, the abnormal heart rate could be fatal if the medication is not discontinued. The increased heart rate is a clear sign of hyperthyroidism resulting from the effects of the drug in the body of the patient (Frandsen & Pennington, 2013). 17. The patient should be advised to take his blood pressure once or twice a day. This is because the hydrocortisone and fludrocortisones is indicated for hepatic disease. One of the possible adverse effects for this therapy influence the blood pressure of patient and if not well monitored, could result into an emergency case (Domino, Baldor, Golding, Grimes, 2013). In addition, carry oral and injectable forms of both medications with him on his trip because, the oral medication may not be useful in case of an emergency where another person has to be involved in administering the medication. The patient should also have a medical identification about the disease and the need for hydrocortisone or other replacement therapy in case of an emergency (Domino, Baldor, Golding & Grimes, 2013). Antimicrobial Agents 18. A client prescribed chloroquine prior to an area where malaria is known to be endemic should remain on the drug for up to 6 weeks after returning because this ensures that the drug kills any remaining malaria parasites that may have been acquired during the trip that are in red blood cells. It also important to ensure that the parasites do not become resistance to the medication if not completely eliminated from the body. Most antimalarial drugs need to be started at least a week in advance and continued for four weeks after the last possible exposures to malaria (World Health Organization, 2010). 19. Metronidazole (Flagyl) has several side effects that the patient should be aware of during the treatment to avoid anxiety. Such side effects include a metallic taste in the mouth, diarrhoea, pain or burning while urinating, headache, sore throat, vomiting, nausea and severe skin reaction. On the other hand, metronidazole may be discontinued once the diarrhoea subsides to minimise adverse effects. Bloody diarrhoea should be reported to the physician for appropriate action to be taken including provision of alternative medications. Antineoplastic drugs 20. An important precaution for cyclosporine is its contraindication in patients with severe renal disease, uncontrolled hypertension, and serious infections (Rakel, 2012). The patient should also be aware of the several side effects including gastrointestinal upset, headache, tremor, hypertension, and renal dysfunction. In addition, the patient must ensure effective monitoring including liver function test and urinalysis (Rakel, 2012). The patient must also provide the physician with a complete and herb list before and during the uptake of the medication. 21. The doctor should monitor the following side effects to prevent the main adverse effects including numbness of the hands and feet, constipation, and diminished reflexes (Rakel, 2012). The drug can also cause urinary retention, muscle weakness and abdominal pain. This is because the drug has been shown to have such side effects, which could be an indication of more adverse effects if proper action is not taken. References Arcangelo, V & Peterson, A. (2006). Pharmacotherapeutics for advanced practice: A practical approach, volume 536. New York, NY: Lippincott Williams & Wilkins. Arcangelo, V & Peterson, A. (2006). Pharmacotherapeutics for advanced practice: a practical approach, volume 536. New York, NY: Lippincott Williams & Wilkins. Aschenbrenner, D & Venable, S. (2009). Drug therapy in nursing. New York, NY: Lippincott Williams & Wilkins. Born, B. (2005). The essential massage companion: Everything you need to know to navigate safely through today's drugs and diseases. London: Concepts Born, llc. Chan, Y. (1995). Adverse interactions between warfarin and nonsteroidal anti-inflammatory drugs: Mechanisms, clinical significance, and avoidance. Ann Pharmacother, 29(12), 1274-83. Domino, F., Baldor, R., Golding, J., & Grimes, J. (2013). The 5-minute clinical consult 2014. New York, NY: Lippincott Williams & Wilkins. Dozor, A & Kelly, K. (2008). The asthma and allergy action plan for kids: A complete program to help your child live a full and active life. London: Simon and Schuster. Frandsen, G., & Pennington, S. (2013). Abrams' clinical drug therapy: Rationales for nursing practice. New York, NY: Lippincott Williams & Wilkins. Griffin, B., Rimmerman, C & Topol, E. (2006). The Cleveland clinical cardiology board review. New York, NY: Lippincott Williams & Wilkins. Rakel, D. (2012). Integrative medicine. London: Elsevier Health Sciences. Shroff, M. (2004). Reference guide for pharmacy licensing exam-questions and answers (naplex), volume 1. London: Krishna Publications Inc. Woodrow, R., Colbert, B & Smith, D. (2010). Essentials of pharmacology for health occupations, (6th, ed). Stamford, CT: Cengage Learning. World Health Organization. (2010). Guidelines for the treatment of malaria. World Health Organization. Read More