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NRP507 Advanced Pharmacology

Week 1 Discussion

Drug Targets and Response

Identify the correct clinical application(s) for each question below using the following pharmacokinetic terms: “absorption,” “distribution,” “metabolism,” “excretion,” “half-life,” “steady-state.”

Answer the following questions in a minimum of 175-300 words:

Why is a Z pack of 5 days an adequate treatment for pneumonia?

Why does a patient starting on levothyroxine need to wait 4-6 weeks before repeating labs to check for therapeutic response to the drug?

What are the implications for a patient on Tegretol who is given a drug that is a CYP-450 inducer?

What are the implications for a patient on Coumadin who is given a drug that is a CYP-450 inhibitor?

Does a drug’s route of administration matter?

What are the implications for an 80-year-old individual with stage 4 chronic renal failure who needs to be prescribed an antibiotic for his pneumonia?

Which pharmacokinetic property is the least familiar to you?

 

NRP507 Advanced Pharmacology

Week 2 Discussion

Ominous Octet

The “Ominous Octet” phrase coined by Dr. Ralph DeFronzo refers to eight main core defects contributing to hyperglycemia, occurring with diabetes.

In a minimum of 175-300 words, provide seven main core defects contributing to hyperglycemia. One main core is already provided in the example below.

Include the following in your response:

Organ: The organ that is contributing to the hyperglycemia

Defect: A phrase to describe the defect

Drug Class: At least one drug class (not drug name)that works on the defect

Mechanism of Action: Explain the mechanism of action

Why is it important for an FNP to understand each defect?

Example

Organ: Pancreas

Defect: Decreased beta cell production

Drug Class: Sulfonylurea

Mechanism of Action: Stimulates release of insulin from beta cells

 

NRP507 Advanced Pharmacology

Week 3 Discussion

Hypertension

Answer the following questions in a minimum of 175-300 words:

A 42-year-old African American male presents with new onset hypertension 148/90. The FNP needs to initiate treatment. Review the most current EBP guidelines for HTN, and discuss what medication you would start him on and why. Justify your answers and cite appropriately. Consider your knowledge of pathophysiology in your decision-making. What nonpharmacological treatment plan would you recommend?

 

NRP507 Advanced Pharmacology

Week 4 Discussion

Prescribing Birth Control

The evidence-based practice (EBP) guidelines changed in 2012 to allow clinicians to prescribe birth control without performing a pap smear until a woman turns age 21. Explain briefly why this change was made. (Hint: related to HPV).

In a minimum of 175-300 words, discuss combination oral contraceptives (COC) and how they are a common choice employed. Ensure you:

Explain briefly the mechanism of action of COCs.

Identify the best candidate for COC.

Explain briefly 3 common side effects.

Discuss cautions and absolute contraindications to prescribing COCs.

Describe the significance of the acronym ACHES and how you as a clinician would communicate this very important information to your patients.

 

NRP507 Advanced Pharmacology

Week 5 Discussion

The Importance of Mechanism of Action for COPD and Asthma

Answer the following questions in a minimum of 175-300 words:

Which core defect of asthma does a SABA address?

Which core defect of asthma does an inhaled corticosteroid (ICS) or ICS/LABA address?

What is important for the patient to know? Why?

What is the difference in mechanism of action (MOA) of a short-acting beta agonist (SABA) vs. a long acting beta agonist (LABA) vs. a long-acting muscarinic antagonists (LAMA). Please explain.

Why would you never prescribe a LABA as monotherapy for a patient with asthma?

 

NRP507 Advanced Pharmacology

Week 6 Discussion

Prescribing for Depression

Answer the following questions in a minimum of 175-300 words:

What is the rationale for having a patient complete a tool for depression or anxiety before prescribing a drug?

You are prescribing a Selective Serotonin Reuptake Inhibitor (SSRI) for depression. Choose two of the following and discuss:

What are a few of the most common side effects of SSRI?

What dosing instructions would you share to help mitigate side effects?

What is a reasonable time frame to have your patient follow-up to assess their response?

What can they expect at this follow-up? Isremission a possibility?

When do you consider a referral?

 

NRP507 Advanced Pharmacology

Week 7 Discussion

Prescribing for Osteoporosis

The Bisphosphonates is the most common drug class used for osteoporosis treatment; there are four drugs in this class. Review the following scenario to answer the questions provided:

Scenario:

You have a 58-year-old Asian patient that had a Dual-Energy X-Ray Absorptiometry (DEXA):

T score of -3.5 (hip), T score of -2.8 (spine). She also drinks 3 cups of tea daily, smokes ½ pack cigarettes x 25 years, BMI 20, + FH osteoporosis (mother), low calcium in diet, does walk a lot in daily life, no fragility fractures, no history steroids, no other meds.

Answer the following questions in a minimum of 175-300 words:

Which one of the bisphosphonate drugs would you recommend for her?

When should she have her next follow-up DEXA?

Would you offer any other specific medication(s)? Why or why not?

What do you believe are two priorities for patient education?

 

NRP507 Advanced Pharmacology

Week 8 Discussion                           

Protein Pump Inhibitors and H2 Blockers

Answer the following questions in a minimum of 175-300 words:

What is the difference in mechanism of action between a PPI and an H2 blocker? Please explain.

Which one offers more blockade of hydrochloric acid?

Why do most of the PPIs need to be prescribed as dose before meals?

What are the implications for long-term use of these medications?

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