NRP507 Week 1 | Pharmacology in Health Care - University of Phoenix

NRP507 Advanced Pharmacology Week 1 Discussion Drug Targets and Response Identify the correct clinical application(s) for each question below using the following pharmacokinetic terms: “absorption,” “distribution,” “metabolism,” “excretion,” “half-life,” “steady-state.”

Answer the following questions in a minimum of 175-300 words:

Why is a Z pack of 5 days an adequate treatment for pneumonia? Why does a patient starting on levothyroxine need to wait 4-6 weeks before repeating labs to check for therapeutic response to the drug? What are the implications for a patient on Tegretol who is given a drug that is a CYP-450 inducer? What are the implications for a patient on Coumadin who is given a drug that is a CYP-450 inhibitor? Does a drug’s route of administration matter? What are the implications for an 80-year-old individual with stage 4 chronic renal failure who needs to be prescribed an antibiotic for his pneumonia? Which pharmacokinetic property is the least familiar to you? NRP507 Advanced Pharmacology Week 2 Discussion Ominous Octet The “Ominous Octet” phrase coined by Dr. Ralph DeFronzo refers to eight main core defects contributing to hyperglycemia, occurring with diabetes. In a minimum of 175-300 words, provide seven main core defects contributing to hyperglycemia. One main core is already provided in the example below.

Include the following in your response:

Organ: The organ that is contributing to the hyperglycemia Defect: A phrase to describe the defect Drug Class: At least one drug class (not drug name)that works on the defect Mechanism of Action: Explain the mechanism of action Why is it important for an FNP to understand each defect? Example Organ: Pancreas Defect: Decreased beta cell production Drug Class: Sulfonylurea Mechanism of Action: Stimulates release of insulin from beta cells NRP507 Advanced Pharmacology Week 3 Discussion Hypertension

Answer the following questions in a minimum of 175-300 words:

A 42-year-old African American male presents with new onset hypertension 148/90. The FNP needs to initiate treatment. Review the most current EBP guidelines for HTN, and discuss what medication you would start him on and why. Justify your answers and cite appropriately. Consider your knowledge of pathophysiology in your decision-making. What nonpharmacological treatment plan would you recommend? NRP507 Advanced Pharmacology Week 4 Discussion Prescribing Birth Control The evidence-based practice (EBP) guidelines changed in 2012 to allow clinicians to prescribe birth control without performing a pap smear until a woman turns age 21. Explain briefly why this change was made. (Hint: related to HPV). In a minimum of 175-300 words, discuss combination oral contraceptives (COC) and how they are a common choice employed. Ensure you: Explain briefly the mechanism of action of COCs. Identify the best candidate for COC. Explain briefly 3 common side effects. Discuss cautions and absolute contraindications to prescribing COCs. Describe the significance of the acronym ACHES and how you as a clinician would communicate this very important information to your patients. NRP507 Advanced Pharmacology Week 5 Discussion The Importance of Mechanism of Action for COPD and Asthma

Answer the following questions in a minimum of 175-300 words:

Which core defect of asthma does a SABA address? Which core defect of asthma does an inhaled corticosteroid (ICS) or ICS/LABA address? What is important for the patient to know? Why? What is the difference in mechanism of action (MOA) of a short-acting beta agonist (SABA) vs. a long acting beta agonist (LABA) vs. a long-acting muscarinic antagonists (LAMA). Please explain. Why would you never prescribe a LABA as monotherapy for a patient with asthma? NRP507 Advanced Pharmacology Week 6 Discussion Prescribing for Depression

Answer the following questions in a minimum of 175-300 words:

What is the rationale for having a patient complete a tool for depression or anxiety before prescribing a drug? You are prescribing a Selective Serotonin Reuptake Inhibitor (SSRI) for depression. Choose two of the following and discuss: What are a few of the most common side effects of SSRI? What dosing instructions would you share to help mitigate side effects? What is a reasonable time frame to have your patient follow-up to assess their response? What can they expect at this follow-up? Isremission a possibility? When do you consider a referral? NRP507 Advanced Pharmacology Week 7 Discussion Prescribing for Osteoporosis The Bisphosphonates is the most common drug class used for osteoporosis treatment; there are four drugs in this class. Review the following scenario to answer the questions provided:

Scenario:

You have a 58-year-old Asian patient that had a Dual-Energy X-Ray Absorptiometry (DEXA): T score of -3.5 (hip), T score of -2.8 (spine). She also drinks 3 cups of tea daily, smokes ½ pack cigarettes x 25 years, BMI 20, + FH osteoporosis (mother), low calcium in diet, does walk a lot in daily life, no fragility fractures, no history steroids, no other meds.

Answer the following questions in a minimum of 175-300 words:

Which one of the bisphosphonate drugs would you recommend for her? When should she have her next follow-up DEXA? Would you offer any other specific medication(s)? Why or why not? What do you believe are two priorities for patient education? NRP507 Advanced Pharmacology Week 8 Discussion Protein Pump Inhibitors and H2 Blockers

Answer the following questions in a minimum of 175-300 words:

What is the difference in mechanism of action between a PPI and an H2 blocker? Please explain. Which one offers more blockade of hydrochloric acid? Why do most of the PPIs need to be prescribed as dose before meals? What are the implications for long-term use of these medications? NRP507 Advanced Pharmacology Week 3 Assignment Patient Case Study: Diabetes Mellitus, Hypertension, Hyperlipidemia This week you gained insight into diabetes, hypertension, and hyperlipidemia, and now it is time to apply your knowledge to complete a case study focused on a patient returning to review his labs. As clinicians, it is essential to be aware of the two main evidence-based guidelines, the American Diabetes Association® (ADA) and the American Association of Clinical Endocrinologists® (AACE), to help you manage patients. For this assignment, use the ADA evidence-based guidelines to answer the questions within the case study. All rights reserved. Case Study: Diabetes Mellitus, Hypertension, Hyperlipidemia Complete the case study by answering the questions associated with the scenario.

DOB: 2/14/72

George Garcia, a 48-year-old Hispanic male, presents for his 3-month follow-up type-2 diabetes mellitus (T2DM) lab review. He is a long-term patient in your practice. He works as an interstate truck driver, so he admits he doesn’t get a chance to exercise, eats a lot of fast food, and drinks 3 cups of coffee and 2 beers/day. He was diagnosed with T2DM 2 years ago and has maxed out on his metformin, refused to start a statin for “fearing the side effects” despite our discussions at each office visit. He has been taking his meds as prescribed and needs refills on everything. His blood pressure was suboptimal at his last visit 3 months ago and his lisinopril was increased from 20mg to 40mg, and he complains of constant throat clearing and an annoying dry cough. He complained of a mild cough in the past and always attributed it to allergies but states this is not allergies. He verbalizes he wishes he had some ideas on how he could make some health changes but finds it hard with his job. He feels sluggish and has decided he wants to try that medicine for cholesterol we discussed in the past. ROS is negative except for his dry cough The exam is normal except has frequent dry hacky cough during the visit ASCVD 10-year risk assessment is >15%. Eye exam: Current: no retinopathy Foot exam: Current: sensation intact to monofilament PMH: HTN, T2DM, Erectile dysfunction. FH: Father: T2DM, MI Mother: T2DM, obesity Sisters x 2: Obesity

Meds:

metformin XR 1000mg 2 tab with dinner lisinopril 40mg 1-tab daily Viagra® 100mg 1-tab prn Allergies: NKDA

VS: BP 142/90 P 82 R 20 BMI 28

CBC: Normal Case Study DM_HTN_HLP NRP/507 v5 Page 2 of 8 CMP: glucose: 116

GFR: 110

Creatinine: 0.9

BUN: 10

K: 4.0

LFTs: all normal urinary albumin-to-creatinine ratio normal

A1C: 7.5

Lipids: TC: 235 Trigs: 190

HDL: 32

LDL: 180

VLDL: 23

Part I: Hypertension (HTN) Analysis of Blood Pressure Control Using the most current ADA EBP guidelines, answer the following questions.