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Pharmacology

Jason tyler is a 65-year-old male admitted to the hospital with a history of chronic cancer pain using morphine sr 60 mg po q8h.

Answer the following questions for A and B in three well-developed paragraphs (450–500 words) using APA formatting, integrating two evidence-based resources to include clinical practice guidelines. As an Advanced Nurse Practitioner (ANP), you are working in an acute care setting. Jason Tyler is a 65-year-old male admitted to the hospital with a history of chronic cancer pain using Morphine SR 60 mg PO q8h. On admission, morphine 2 mg IV q4h was ordered. The patient reports his pain only went from a 9 to an 8 after the morphine dose and is asking for more pain medication. The staff begins to question the motivation of the patient and if addiction is present. The resident decides to start a PCA for his pain. In a few hours, the patient is comfortable, resting in bed. A: Answer the following questions and provide your rationales for your choices. J.T.’s behavior is best described as: (Please provide the definition for your choice and your rationales) Tolerance Addiction Pseudo addiction Dependence During his hospital stay, J.T. went into acute renal failure. He is increasingly lethargic and is experiencing confusion and some hallucinations. The physician believes the morphine metabolites may be responsible and would like to convert to an alternative regimen. What would be your recommendation? Change opioid to fentanyl patch 50 mcg q72h. Decrease morphine SR dose to 60 mg PO q8h. Switch to hydromorphone 8 mg orally q4h as needed. Add haloperidol 1 mg PO q6h. Tolerance will not develop to which adverse opioid effect? Respiratory depression Sedation Constipation Nausea B: What pieces of the holistic assessment are missing from this scenario: (Answer the following questions and provide your rationales) As a healthcare provider, what else do you need to understand about this patient related to pain management? In your response please provide the teaching you would provide to JT. What is meant by the DEA Drug Classification Schedule? Explain each category/classification.

Categories
Pharmacology

He never followed up and has been taking over-the-counter antacids and histamine receptor antagonists (h2ras) for 2 weeks without relief.

Joshua George is a 42-year-old white man presenting with a 2-month history of intermittent mid-epigastric pain. The pain sometimes wakes him up at night and seems to get better after he eats a meal. J.G. informs you that his doctor told him that he had an infection in his stomach 6 months ago. He never followed up and has been taking over-the-counter antacids and histamine receptor antagonists (H2Ras) for 2 weeks without relief. He takes no other medications. He is concerned because the pain is continuing. He has no other significant history except he is a 20-pack-year smoker and he drinks 5 cups of coffee a day. He eats late at night and goes to bed about 30 minutes after dinner. He is allergic to penicillin. Diagnosis: Peptic Ulcer Disease List specific goals for treatment for J.G. What drug therapy would you prescribe for J.G.? Please provide your rationale. What are the parameters for monitoring the success of the therapy? Discuss specific patient education based on the prescribed therapy. List one or two adverse reactions for the selected agent that would cause you to change therapy. What would be the choice for second-line therapy? What over-the-counter and/or alternative medications would be appropriate for J.G.? What lifestyle changes would you recommend to J.G.? Describe one or two drug-drug or drug-food interactions for the selected agent.

Categories
Pharmacology

Answer the following questions in three well-developed paragraphs (450–500 words

Answer the following questions in three well-developed paragraphs (450–500 words) using APA formatting, integrating two evidence-based resources. Topic: Heart Failure Michael, age 62, is a male who is new to your practice. He is reporting shortness of breath on exertion, especially after climbing steps or walking three to four blocks. His symptoms clear with rest. He also has difficulty sleeping at night (he tells you he needs two pillows to be comfortable). He tells you that 2 years ago, he suddenly became short of breath after hurrying for an airplane. He was admitted to a hospital and treated for acute pulmonary edema. Three days before the episode of pulmonary edema, he had an upper respiratory tract infection with fever and mild cough. After the episode of pulmonary edema, his blood pressure has been consistently elevated. His previous physician started him on a sustained-release preparation of diltiazem 180 mg/d. Medical History: His medical history includes moderate prostatic hypertrophy for 5 years, adult-onset diabetes mellitus for 10 years, hypertension for 10 years, and degenerative joint disease for 5 years. Medications: His medication history includes hydrochlorothiazide (HydroDIURIL) 50 mg/d, atenolol (Tenormin) 100 mg/d, controlled-delivery diltiazem 180 mg/d, glyburide (DiaBeta) 5 mg/d, and indomethacin (Indocin) 25 to 50 mg three times a day as needed for pain. While reviewing his medical records, you see that his last physical examination revealed a blood pressure of 160/95 mm Hg, a pulse of 95 bpm, a respiratory rate of 18, normal peripheral pulses, mild edema bilaterally in his feet, a prominent S3 and S4, neck vein distention, and an enlarged liver. Diagnosis: Heart Failure Class II 1 List specific goals of treatment for Michael. 2 What drug(s) would you prescribe? Please provide rationales. 3 What are the parameters for monitoring the success of your selected therapy? 4 Discuss specific patient education based on the prescribed therapy. 5 Describe one or two drug–drug or drug–food interactions for the selected agent(s). 6 List one or two adverse reactions for the selected agent(s) that would cause you to change therapy. 7 What would be the choice for the second-line therapy? 8 What over-the-counter or alternative medications would be appropriate for Michael? 9 What dietary and lifestyle changes should be recommended for Michael

Categories
Pharmacology

Case Study – Dislipidemia Jeremy, age 55 white male, has come in for his annual

Case Study – Dislipidemia Jeremy, age 55 white male, has come in for his annual physical. He has hypertension and type 2 diabetes mellitus. His blood pressure is controlled with lisinopril 20 mg daily and amlodipine 5 mg daily, NKA, and denied any hx of smoking. His most recent HbA1c was 7.2% while taking metformin 500 mg twice a day. His father died at age 55 of a myocardial infarction, and his brother, age 57, just underwent angioplasty. Jeremy eats fast food at least five times a week because of his work schedule. He weighs 245 lb and stands 5-foot-11. His fasting blood sugar is 213. His blood pressure is 134/80. His total cholesterol is 237 (LDL, 162; HDL, 35; triglycerides, 200). 1. Does Jeremy fall into any of the statin risk categories? If so, which one? 2. What drug therapy and dose would you prescribe, and why? 3. What are the parameters for monitoring the success of the therapy? 4. List one or two adverse reactions for the drug therapy that you prescribed for Jeremy that would cause you to change therapy. Provide rationale for your answer. 5. When rechecked, Jeremy’s total cholesterol is 174 (LDL, 100; HDL, 38), but he is complaining of muscle pain. How would you manage Jeremy’s treatment? Provide rationale for your answer. 6. When would you have patient follow up? 7. What labs would you order and why?

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Pharmacology

basic research essay on the drug tiotropium bromide (Spiriva) . ill include the

basic research essay on the drug tiotropium bromide (Spiriva) . ill include the guidlines in the attachment , itll say it for a presentation but its for the essay as well

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Pharmacology

The subject is NURSING/PHARMACOLOGY. NO PLAGIARISM OR YOU CANNOT BE PAID. The ru

The subject is NURSING/PHARMACOLOGY. NO PLAGIARISM OR YOU CANNOT BE PAID. The rubric is attached so please review. Thank you in advance. If any questions arise, please let me know!
The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable, since very few drugs have been specifically researched and tested with children.
When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion
Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.
To Prepare
Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
Reflect on situations in which children should be prescribed drugs for off-label use.
Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.
Write a 1-page narrative in APA format that addresses the following:
Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.