Week 7: Musculoskeletal System

Discussion Topic: WEEK 7: Musculoskeletal System WEEK 7: Musculoskeletal System
Class,

Welcome to week 7! This week we will apply pharmacology concepts to musculoskeletal system disorders. We will cover the topics of NSAIDs, DMARDs, opioids, and muscles relaxants in relation to the treatment of arthritis, RA, gout, and addiction.

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.

 

ASSIGNMENT

Submit your Assignment by Day 7 of Week 7 (Sunday night, 11:59 pm ET)

Case studies are a useful way for you to apply your knowledge of pharmacokinetics and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.

For your week 7 assignment, evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.

To Prepare:

Review assignment rubric and case studies. Be sure to thoroughly answer ALL questions.
Explain the problem and discuss how you would address the problem.
When recommending medications, write out a complete prescription for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, special instructions, # dispensed (days supply), refills, etc. Also state if you would continue, discontinue or taper the patient’s current medications.
Answer questions using your required learning resources, clinical practice guidelines, Medscape and JNC 8.
Include at least three references to support each scenario and cite them in APA format. Please include in-text citations. You do not need an introduction or conclusion paragraph.

WEEK 7 ASSIGNMENT

SCENARIO 1

Sandra is a 52-year-old female with past medical history of hypertension and GERD. Current medications include pantoprazole 40 mg po daily 30 minutes before breakfast and HCTZ 50 mg daily. She smokes 1 pack per day and presents with persistent sadness, anxiety and “empty mood.” Her smoking habit has increased the past month as she says it “helps calm her nerves.” She denies any history of seizures. How would you treat Sandra? What medication would you prescribe (include complete medication order)? What education would you provide to the patient? What labs would you order?

SCENARIO 2

Patient JR is experiencing symptoms of pain, numbness and tingling in his legs. He states he sometimes has trouble keeping his balance and feels easily fatigued. He is currently on metformin 1000 mg po BID, Synjardy XR 5/1000mg po daily, Tresiba 20 units SC daily and rosuvastatin 10 mg po daily. What is your working diagnosis? How would you treat JR and improve his treatment? What would you monitor?

SCENARIO 3

Zolpidem has a half-life of 3 hours. If a patient takes 10 mg at 10 pm, what will the blood level be at 7 am? Do elderly patients need a smaller dosage of zolpidem? Name 3 antidepressants/antipsychotics you might prescribe for patients with co-existing depression and insomnia (include complete medication orders) and include patient monitoring.

SCENARIO 4

A mother brings her 7-year-old son David into the clinic today stating that he is increasingly getting into trouble at school. He “fidgets and frequently leaves his seat, does not listen to his teacher, talks excessively and interrupts other classmates.” What would you prescribe for David? How common is it for a parent and child to both have ADHD? How are symptoms and treatment of ADHD different between children and adults? What would you prescribe for David’s 40-year-old mother with ADHD?

 

 

Note on Assignment Attempts

Students are expected to review their work and submissions of work carefully prior to due dates. Unless otherwise approved by the faculty, students are allowed one submission of graded work per assignment. While the classroom allows for multiple submissions, once an assignment is graded, submissions will no longer be accepted unless approved by the faculty. If an assignment is submitted prior to the assignment deadline and has not yet been graded, then students may submit a revised assignment prior to the assignment deadline. Once the deadline has passed, resubmission is not permitted.

 

 

Late Assignment Policy

Students are expected to submit assignments by the due dates noted in the course and welcome announcement. In extenuating circumstances, such as illness, the student must contact the instructor as soon as possible to discuss the situation. In those circumstances, faculty will determine the appropriate course of action for the student. Depending on the situation, these actions may include recommendations to drop the course (if within the university drop/withdrawal period), acceptance of some or all of the overdue assignments with or without penalties, or failure to accept assignments.

 

Assignments submitted late without the prior agreement of the instructor, outside of an emergency absence, or in violation of agreements for late submission, will receive a grade reduction for the assignment amounting up to 20%. Each day late will result in a 4% point deduction up to day 5. After 5 days, the assignment will be graded a zero.

Wishing you much success,

Dr. White

 

 

EXTRA LEARNING

The following is an interactive case study on Complex Regional Pain Disorder:

http://cdn-media.waldenu.edu/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_07/index.html

 

The following is a great quiz on controlled substances:

https://denalirx.com/controlled-substance-quiz/ Links to an external site.

 

1. Which medication does not have anticholinergic side effects?

Acetirizine

Bdiphenhydramine

Cdicyclomine

Dbenztropine

Ecyclobenzaprine

 

2. All of the following medications treat gout except

Asulfinpyrazone

Bmesalamine

Ccolchicine

Dallopurinol

Eprobenecid

 

3. Which of the following is a non-narcotic pain medication?

Atramadol

Bfentanyl

Ctoradol

Dmeperidine

Ecodeine

 

Answers

1) A

2) B

3) C

 

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