Pharmacology case studies

Pharmacology case studies

Case Studies for Week 2

Case studies in pharmacology: M.T., an 18-month-old, 20-kg male, arrives at the emergency department with status epilepticus that has lasted approximately 20 minutes. He was driven to the emergency room from a small town in a family vehicle. At this point, he has received no medical attention. The nursing staff attempted several intravenous line insertions but were unsuccessful. M.T. continues to convulse incessantly.

1. Which of the following routes of administration for an anticonvulsant would be most appropriate for M.T., and why?

a) Intramural

b) Transcutaneous

c) The subcutaneous

d) Rectal surgery

2. Midazolam is a benzodiazepine that can be used to treat status epilepticus effectively. When intravenous access is unavailable, which of the following routes of administration has been used effectively to deliver midazolam?

a) Transcutaneous

b) Mucous membrane

c) Oral

d) The subcutaneous

3. Which of the following statements about medication absorption through the skin is correct?

a) Compound absorption is inversely proportional to skin thickness.

b) Compound absorption is inversely proportional to skin hydration.

c) When compared to older children and adults, infants and young children have a lower body surface area (BSA) relative to body mass.

d) Medication administration through the skin is reliable and safe in infants and young children.

4. What are the advantages of using the mucosal route of treatment?

a) When administered via nasal spray, some medications have very good absorption and systemic effect.

b) Nasal (mucosal) administration avoids the trauma of placing an intravenous line.

c) Nasal medication administration is usually less expensive than intravenous administration.

d) The mucosal route of administration has all of the advantages listed above.

K.F. is a 23-year-old woman with acne and bipolar disorder. She is currently taking lithium for bipolar disorder and isotretinoin (Accutane) for acne. She also takes famotidine on occasion for reflux.

1. Which of the following medications would be considered safe for K.F. to continue taking if she became pregnant? Why? What makes the others unsafe during pregnancy (pregnancy rating, potential adverse fetal and maternal effects)?

Accutane a)

Lithium b)

Famotidine c)

2. K.F. returns to your clinic a year later. Her acne and bipolar medication have been stopped, and she is now 4 months pregnant with a complaint of pain and rising fever over the last 5 days. Lab tests reveal gram-negative bacilli, and the Widal test is positive. Which of the following medications is most likely to be administered, and why? Why will the other drugs not be given?

Ampicillin (a)

Ciprofloxacin b)

Levofloxacin c)

Tetracycline (d)

Case studies in pharmacology

R.S. is an 85-year-old woman suffering from congestive heart failure. She has been hospitalized four times in the last three months. R.S., like many older adults, is having difficulty swallowing and is experiencing psychologic changes that are interfering with her medication absorption.

1. Which of the following would be a good place to start looking for reasons for R.S.’s frequent hospitalizations?

a) Simply inquire whether she is taking her medications as prescribed.

b) Assume that her frequent hospitalizations are due to expected changes that are part of aging.

c) Examine all of R.S.’s medication vials to complete an adherence assessment, including pill count.

d) Assume that her frequent hospitalizations are due to inadequate treatment of her conditions.

2. Assessing R.S.’s life expectancy should never be considered when deciding on the best course of treatment. Rather, the same course of treatment should be followed regardless of life expectancy. WHY?

a) True

b) False

3. Which of the following best describes R.S.’s concern about taking OTCs that may impair her cardiac function?

a) Assume that if R.S. has not discussed her use of OTCs with her doctors, this is most likely not an issue.

b) Assume that because older adults do not typically take OTCs, this is not an issue with R.S.

c) Because older adults take a significant number of OTCs without the knowledge of their physicians, R.S.’s use is best assessed through a home visit and open-ended questions.

L.L., a 67-year-old man, was diagnosed with benign prostatic hypertrophy (BPH). He is having problems urinating. He is currently on Cozaar 100 mg qd for HTN and his BP is well controlled. He is not on any other medications. The doctor has recommended medication for his BPH, but he would like to try an herbal supplement before taking prescription medication.

1. What herbal supplement should he take?

2 .What is the recommended dosage?

3. What are possible side effects and/or drug interactions of the herbal supplement?

4. What warnings should you give L.S. before he starts the herbal supplement?

M.C. is a 54-year-old female who presents with menopausal symptoms of hot flashes, mood swings, decreased libido and vaginal dryness. She wishes to try an herbal supplement to reduce her symptoms, as she is concerned about potential side effects of prescription medications.

1. What herbal supplement would you recommend?

2. What is the recommended dosage?

3. What are possible side effects and/or drug interactions of the herbal supplement?

4. What warnings should you give M.C. before she starts the herbal supplement?

P.K. is a 26-year-old female who presents with depression and anxiety. She is hesitant to start prescription antidepressants as she feels their use will negatively affect her libido and sexual function. She states that she has been taking St. John’s worth for the past couple of weeks and wishes to know if this supplement is okay to use.

1. What are possible side effects and/or drug interactions of the herbal supplement?

2. What warnings should you give P.K. about the herbal supplement?

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed

• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• The is a great resource