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NRP507 Advanced Pharmacology

Week 5 Assignment

Patient Case Study: Asthma

Based on the knowledge you have gained up to this point, it is time to apply your skills to determine the proper treatment plan for a patient presenting with asthma exacerbation.

CASE STUDY:

Asthma

Complete the case study by answering the questions associated with the scenario.

DOB: 2/3/1984

Nancy Smith, a 35-year-old female, presents with an asthma exacerbation. She was diagnosed with asthma at age 20 and

has been only using an albuterol inhaler p.r.n. (when necessary). She has been seen in urgent care a few times over the past year (most recently 4 months ago) and was given a prescription for an inhaled steroid (this one she never filled), albuterol inhaler, and oral steroids. Her asthma symptoms flared again 2 weeks ago, and she has been using her albuterol 3-4 times/day. She reports that she is very short of breath when climbing stairs or when walking to the mailbox. She has had nighttime coughing spells every day during the past week and has had to prop herself up on pillows to breathe. She indicates that she has had similar previous flares in the past and she “just wants more albuterol and steroid pills.”

Meds:

Proair HFA

Claritin prn

Spirometry: FEV1: 58%

FEV1/FVC ratio: 69%

Pulse ox: 93% on RA

Analysis of Asthma Stage

Refer to the most current UpToDate® evidence based guidelines (EBG) for asthma located in the University Library to answer the following questions:

1. Synthesize the patient’s overall social and medical history, clinical symptoms, and clinical assessment to classify her asthma using EBG. Which of the 4 categories (intermittent, persistent mild, persistent – moderate, persistent – severe) does she fall under? Explain your justification.

2. From a pathophysiological perspective, what is the danger with her current treatment plan execution regarding her SABA use? Explain your answer.

Plan of Care and Prescription Writing

1. What is your evidence-based medication treatment plan? Please do NOT use the Alternative treatment plan listed in the guidelines for this case study. Based on your analysis, write a minimum of 3 prescriptions the patient will need using the templates provided. One prescription needs to include a steroid burst.

Excellence in Health Care, LLC.

DEA #

Name Date

DOB

Rx:

Sig:

Qty:

RF:

Signature

Dispense as Written Substitution Permissible

Excellence in Health Care, LLC.

DEA #

Name Date

DOB

Rx:

Sig:

Qty:

RF:

Signature

Dispense as Written Substitution Permissible

Excellence in Health Care, LLC.

DEA #

Name Date

DOB

Rx:

Sig:

Qty:

RF:

Signature

Dispense as Written Substitution Permissible

Mechanism of Action, Monitoring, and Patient Education

1. Explain the mechanism of action of each medication you are prescribing and how it addresses the patient’s asthma exacerbation. When would you see her back for a follow-up appointment?

2. Outline appropriate monitoring for drug side effects, laboratory monitoring with rationale, and follow-up.

3. Discuss the specific, realistic patient education you would provide and how you would tailor your information to Nancy to facilitate treatment adherence and understanding.

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