What are the errors in the following prescriptions (1 per prescription)? Rewrite each prescription correctly. What is each medication’s classification and mechanism of action (MOA)? · rivoraxaban 20 mg PO daily with evening meal #30 0RF
Welcome to week 9! This week we will apply pharmacology concepts to disorders associated with women and men’s health, such as hormone deficiencies, cancers, and other functional and structural abnormalities. Your Learning Resources also include material on eye, ear, and skin disorders and pharmacologic treatment.
When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.
WEEK 9 ASSIGNMENT (covers weeks 9-11)
Submit your Assignment by Day 7 of Week 9 (Sunday night, 11:59 pm ET).
Case studies are a useful way for you to apply your knowledge of pharmacokinetic and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.
For your week 9 assignment, evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.
Directions: For each of the scenarios below, answer the questions using your required learning resources, Medscape, and clinical practice guidelines (ie AHA, ACC, ADA,
GINA). When recommending medications, write out a complete prescription for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, # dispensed (days supply), refills, special instructions etc. Also state if you would continue, discontinue or taper the patient’s current medications (if applicable). Use at least 3 sources for each scenario and cite sources using APA format. LIST REFERENCES AFTER EACH SCENARIO.
SCENARIO 1
What are the errors in the following prescriptions (1 per prescription)? Rewrite each prescription correctly. What is each medication’s classification and mechanism of action (MOA)?
· rivoraxaban 20 mg PO daily with evening meal #30 0RF
· tamsulosin (Proscar) 0.4 mg po daily, 30 minutes after the same meal each day #30 2 RF
· Bactrim DS (sulfamethoxazole/trimethoprim 875/125 mg) po twice daily for 7 days for UTI #14 0RF
· cephalexin (Cefzil) 500 mg po QID x 7 days #28 0 RF
· ciprofloxacin 0.3% otic solution for bacterial conjunctivitis; instill 1-2 drops into eye every 2 hours while awake for 2 days then 1-2 drops every 4 hours while awake for the next 5 days #1 bottle 0 RF
SCENARIO 2
FL is 48-year-old woman presenting with hot flashes related to menopause. Current medical conditions include hypertension and ADHD. She reports that stimulant medications caused significant insomnia and appetite suppression in the past. She is seeking a single medication that may help manage more than one of her conditions.
Which of the following medications would be the most appropriate choice for this patient? WHY? What is the medication’s MOA and what would you monitor?
A. estradiol 1 mg PO daily
B. progesterone 200 mg PO at bedtime
C. venlafaxine XR 75 mg PO daily
D. clonidine 0.1 mg PO twice daily
E. bupropion XL 150 mg PO daily
SCENARIO 3
TN is a 26-year-old female presenting with thick white, odorless vaginal discharge and itching for 2 days. She is sexually active and has had unprotected sex with a new male partner for the last month. Current medications include fluoxetine 20 mg po daily, valacyclovir 500 mg po daily, zolpidem 10 mg po qHS, Depo-Provera 150 mg IM q3 months. TN reports drinking kava several times a day. She is allergic to sulfa drugs. What medication would you prescribe for TN (include complete medication order)? What is a possible differential diagnosis? How long should she abstain from sexual activity? What patient education would you provide?
SCENARIO 4
GA (70 kg patient) is prescribed vancomycin 15 mg/kg IV every 12 hours. The pharmacy stocks vancomycin 1 g per 20 mL vials.
1. How much vancomycin (mg) should be administered per dose?
2. How many milliliters of vancomycin solution should be drawn up for each dose?
3. If the infusion rate is 10 mg/min, how long will it take to administer one dose?
4. A trough level is drawn 30 minutes before the 4th dose, and the result is 9 mcg/mL. Is the current dosing regimen appropriate based on the trough level? Would you increase, decrease, or leave the dose the same? Please include a complete medication order. What are risks associated with vancomycin therapy?
5. Why is vancomycin usually given IV and not PO? How does this relate to bioavailability?
To Prepare:
- Review the case study posted in “Announcements” by your Instructor for this Assignment
- Review the information provided and answer questions posed in the case study
- When recommending a medication, write out a complete prescription for the medication
- Whenever possible, use clinical practice guidelines in developing your answers when possible
- Include at least three references to support your answer and cite them in APA format.
· NURS_6521_Week9_Assignment_Rubric
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NURS_6521_Week9_Assignment_Rubric |
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Criteria |
Ratings |
Pts |
|
This criterion is linked
to a Learning OutcomeScenario 1:
Appropriate medication is prescribed or changed. Rationale provided and
includes current literature to support decision. All aspects of the patient
history are considered in making the medication selection. |
15 to
>11.0 ptsExcellentMedication selected is appropriate and considers all of
the unique patient characteristics. Rationale for selection is clear,
complete, and appropriate. 11 to
>7.0 ptsGoodMedication
selected might be appropriate but conflicts with the unique patient
characteristics. Rationale for selection is clear but lacks discussion about
potential prescribing issues. 7 to
>3.0 ptsFairMedication
selected is not appropriate for this patient unique characteristics.
Rationale provided is not correct or is flawed in applying the medication to
this patient. 3 to
>0 ptsPoorMedication selected is
inappropriate or would not be provided based on patient unique
characteristics. |
15 pts |
|
This criterion is linked
to a Learning OutcomeScenario 1: Written
medication orders include all 5 aspects required for a valid order. The order
is complete, accurate, and appropriate. |
3 ptsCompleteWritten medication orders includes
all 5 aspects required for a valid order. The order is complete, accurate,
and appropriate. 0 ptsPoorThe prescription is incomplete.
Aspects of a complete order are missing. The order is either incomplete,
inaccurate, or inappropriate. |
3 pts |
|
This criterion is linked
to a Learning OutcomeScenario 1: References
for the scenario are within past 5 years and include the appropriate clinical
practice guideline if applicable. |
4 ptsExcellentReferences for the scenario are
within past 5 years and include the appropriate clinical practice guideline
if applicable. Correct APA format is used. 3 ptsGoodReferences for the scenario are
within past 5 years but do not include the appropriate clinical practice
guideline if applicable. Contains a few (1 or 2) APA format errors. 2 ptsFairReferences for the scenario are not
from within the past 5 years or do not reflect the content of this scenario
and do not include the appropriate clinical practice guideline if applicable.
Contains several (3 or 4) APA format errors. 0 ptsPoorNo references are included.
References do not reflect the content of this scenario. Appropriate clinical
practice guideline is not include. Contains many (≥ 5) APA format errors. |
4 pts |
|
This criterion is linked
to a Learning OutcomeScenario 1: Written
Expression and Formatting - English writing standards: Correct grammar,
mechanics, and proper punctuation |
3 ptsExcellentUses correct grammar, spelling, and
punctuation with no errors. 2 ptsGoodContains a few (1 or 2) grammar,
spelling, and punctuation errors. 1 ptsFairContains several (3 or 4) grammar,
spelling, and punctuation errors. 0 ptsPoorContains many (≥ 5) grammar,
spelling, and punctuation errors that interfere with the reader’s
understanding. |
3 pts |
|
This criterion is linked
to a Learning OutcomeScenario 2:
Appropriate medication is prescribed or changed. Rationale provided and
includes current literature to support decision. All aspects of the patient
history are considered in making the medication selection. |
15 to
>11.0 ptsExcellentMedication selected is appropriate and considers all of
the unique patient characteristics. Rationale for selection is clear,
complete, and appropriate. 11 to
>7.0 ptsGoodMedication
selected might be appropriate but conflicts with the unique patient
characteristics. Rationale for selection is clear but lacks discussion about
potential prescribing issues. 7 to
>3.0 ptsFairMedication
selected is not appropriate for this patient unique characteristics.
Rationale provided is not correct or is flawed in applying the medication to
this patient. 3 to
>0 ptsPoorMedication selected is
inappropriate or would not be provided based on patient unique
characteristics. |
15 pts |
|
This criterion is linked
to a Learning OutcomeScenario 2: Written
medication orders include all 5 aspects required for a valid order. The order
is complete, accurate, and appropriate. |
3 ptsCompleteWritten medication orders includes
all 5 aspects required for a valid order. The order is complete, accurate,
and appropriate. 0 ptsPoorThe prescription is incomplete.
Aspects of a complete order are missing. The order is either incomplete,
inaccurate, or inappropriate. |
3 pts |
|
This criterion is linked
to a Learning OutcomeScenario 2: References
for the scenario are within past 5 years and include the appropriate clinical
practice guideline if applicable. |
4 ptsExcellentReferences for the scenario are
within past 5 years and include the appropriate clinical practice guideline
if applicable. Correct APA format is used. 3 ptsGoodReferences for the scenario are
within past 5 years but do not include the appropriate clinical practice
guideline if applicable. Contains a few (1 or 2) APA format errors. 2 ptsFairReferences for the scenario are not
from within the past 5 years or do not reflect the content of this scenario
and do not include the appropriate clinical practice guideline if applicable.
Contains several (3 or 4) APA format errors. 0 ptsPoorNo references are included.
References do not reflect the content of this scenario. Appropriate clinical
practice guideline is not include. Contains many (≥ 5) APA format errors. |
4 pts |
|
This criterion is linked
to a Learning OutcomeScenario 2: Written
Expression and Formatting - English writing standards: Correct grammar,
mechanics, and proper punctuation |
3 ptsExcellentUses correct grammar, spelling, and
punctuation with no errors. 2 ptsGoodContains a few (1 or 2) grammar,
spelling, and punctuation errors. 1 ptsFairContains several (3 or 4) grammar,
spelling, and punctuation errors. 0 ptsPoorContains many (≥ 5) grammar,
spelling, and punctuation errors that interfere with the reader’s
understanding. |
3 pts |
|
This criterion is linked
to a Learning OutcomeScenario 3:
Appropriate medication is prescribed or changed. Rationale provided and
includes current literature to support decision. All aspects of the patient
history are considered in making the medication selection. |
15 to
>11.0 ptsExcellentMedication selected is appropriate and considers all of
the unique patient characteristics. Rationale for selection is clear,
complete, and appropriate. 11 to
>7.0 ptsGoodMedication
selected might be appropriate but conflicts with the unique patient
characteristics. Rationale for selection is clear but lacks discussion about
potential prescribing issues. 7 to
>3.0 ptsFairMedication
selected is not appropriate for this patient unique characteristics.
Rationale provided is not correct or is flawed in applying the medication to
this patient. 3 to
>0 ptsPoorMedication selected is
inappropriate or would not be provided based on patient unique
characteristics. |
15 pts |
|
This criterion is linked
to a Learning OutcomeScenario 3: Written
medication orders include all 5 aspects required for a valid order. The order
is complete, accurate, and appropriate. |
3 ptsCompleteWritten medication orders includes
all 5 aspects required for a valid order. The order is complete, accurate,
and appropriate. 0 ptsPoorThe prescription is incomplete.
Aspects of a complete order are missing. The order is either incomplete,
inaccurate, or inappropriate. |
3 pts |
|
This criterion is linked
to a Learning OutcomeScenario 3: References
for the scenario are within past 5 years and include the appropriate clinical
practice guideline if applicable. |
4 ptsExcellentReferences for the scenario are
within past 5 years and include the appropriate clinical practice guideline
if applicable. Correct APA format is used. 3 ptsGoodReferences for the scenario are
within past 5 years but do not include the appropriate clinical practice guideline
if applicable. Contains a few (1 or 2) APA format errors. 2 ptsFairReferences for the scenario are not
from within the past 5 years or do not reflect the content of this scenario
and do not include the appropriate clinical practice guideline if applicable.
Contains several (3 or 4) APA format errors. 0 ptsPoorNo references are included.
References do not reflect the content of this scenario. Appropriate clinical
practice guideline is not include. Contains many (≥ 5) APA format errors. |
4 pts |
|
This criterion is linked
to a Learning OutcomeScenario 3: Written
Expression and Formatting - English writing standards: Correct grammar,
mechanics, and proper punctuation |
3 ptsExcellentUses correct grammar, spelling, and
punctuation with no errors. 2 ptsGoodContains a few (1 or 2) grammar,
spelling, and punctuation errors. 1 ptsFairContains several (3 or 4) grammar,
spelling, and punctuation errors. 0 ptsPoorContains many (≥ 5) grammar,
spelling, and punctuation errors that interfere with the reader’s understanding. |
3 pts |
|
This criterion is linked
to a Learning OutcomeScenario 4:
Appropriate medication is prescribed or changed. Rationale provided and
includes current literature to support decision. All aspects of the patient
history are considered in making the medication selection. |
15 to
>11.0 ptsExcellentMedication selected is appropriate and considers all of
the unique patient characteristics. Rationale for selection is clear,
complete, and appropriate. 11 to
>7.0 ptsGoodMedication
selected might be appropriate but conflicts with the unique patient
characteristics. Rationale for selection is clear but lacks discussion about
potential prescribing issues. 7 to
>3.0 ptsFairMedication
selected is not appropriate for this patient unique characteristics.
Rationale provided is not correct or is flawed in applying the medication to
this patient. 3 to
>0 ptsPoorMedication selected is
inappropriate or would not be provided based on patient unique
characteristics. |
15 pts |
|
This criterion is linked
to a Learning OutcomeScenario 4: Written
medication orders include all 5 aspects required for a valid order. The order
is complete, accurate, and appropriate. |
3 ptsCompleteWritten medication orders includes
all 5 aspects required for a valid order. The order is complete, accurate,
and appropriate. 0 ptsPoorThe prescription is incomplete.
Aspects of a complete order are missing. The order is either incomplete,
inaccurate, or inappropriate. |
3 pts |
|
This criterion is linked
to a Learning OutcomeScenario 4: References
for the scenario are within past 5 years and include the appropriate clinical
practice guideline if applicable. |
4 ptsExcellentReferences for the scenario are
within past 5 years and include the appropriate clinical practice guideline
if applicable. Correct APA format is used. 3 ptsGoodReferences for the scenario are
within past 5 years but do not include the appropriate clinical practice guideline
if applicable. Contains a few (1 or 2) APA format errors. 2 ptsFairReferences for the scenario are not
from within the past 5 years or do not reflect the content of this scenario
and do not include the appropriate clinical practice guideline if applicable.
Contains several (3 or 4) APA format errors. 0 ptsPoorNo references are included.
References do not reflect the content of this scenario. Appropriate clinical
practice guideline is not include. Contains many (≥ 5) APA format errors. |
4 pts |
|
This criterion is linked
to a Learning OutcomeScenario 4: Written
Expression and Formatting - English writing standards: Correct grammar,
mechanics, and proper punctuation |
3 ptsExcellentUses correct grammar, spelling, and
punctuation with no errors. 2 ptsGoodContains a few (1 or 2) grammar,
spelling, and punctuation errors. 1 ptsFairContains several (3 or 4) grammar,
spelling, and punctuation errors. 0 ptsPoorContains many (≥ 5) grammar,
spelling, and punctuation errors that interfere with the reader’s understanding. |
3 pts |
· Total Points: 100
