Drug Treatments To Address The Patient Pathophysiology Discussion Paper
Discussion Post Response:
Provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples. NEED 2 REFERENCES
CASE STUDY:
A 68-year-old male has been admitted to the medical-surgical unit for community-acquired pneumonia for three days. The patient has a history of COPD, hypertension, hyperlipidemia, and diabetes. He is on day three of empiric antibiotics, ceftriaxone 1GM IV Daily and Azithromycin 500MG IV Daily. Clinical status has improved since admission, with decreased oxygen requirements. However, the patient cannot tolerate intake due to complaints of nausea and vomiting—penicillin allergy (rash). Drug Treatments To Address The Patient’s Pathophysiology Discussion Paper
ORDER HERE A PLAGIARISM-FREE PAPER HERE
Microorganisms for community-acquired pneumonia are streptococcus pneumoniae, haemophilus influenzae, staphylococcus aureus, mycoplasma pneumoniae, chlamydia pneumoniae, moraxellacatarrhalis legionella pneumophila, Influenza, Rhinovirus, and Coronavirus (McCance & Huether, 2019). The goal in determining the appropriate treatment is ensuring that organisms are susceptible to antibiotic treatment; broad-spectrum antibiotics are often used for initial treatment in pneumonia until cultures identify a specific organism and reveal antibiotic sensitivities. The first step in managing pneumonia is establishing adequate ventilation and oxygenation (McCance & Huether, 2019); since the patient has decreased oxygen requirements, we will need to continue to monitor for respiratory discomfort, considering the history of COPD. However, PRN orders for Oxygen 2L via nasal cannula for respiratory discomfort will be necessary. This patient will also need an order for a spirometer, with instructions to utilize it at least every hour. Treatment will consist of antibiotics and supportive therapy to address symptoms the patient may experience, such as respiratory issues and nausea/vomiting. Recommendations for the treatment regimen for this patient are to continue with Azithromycin and Ceftriaxone, especially since treatment has been effective, as evidenced by improvement in clinical status. Both medications are effective alternatives for Penicillin allergy patients (Rosenthal & Burchum, 2019). Azithromycin classifies as a macrolide. This drug classification is preferred for respiratory infections such as pneumonia caused by mycobacterium (a community-acquired organism) and for patients with a penicillin allergy (Rosenthal & Burchum, 2019). Ceftriaxone classifies as a cephalosporin; it is a broad-spectrum antibiotic and categorized as a third-generation drug, making it highly effective against bacteria with good distribution; it is also considered a safe and well-tolerated drug (Rosenthal & Burchum, 2019). A short-term, tapered dose of IV steroid treatment is recommended for respiratory inflammation; studies show that administering steroids decreases mortality rates and decreases hospital length of stay (Nadler, 2020). Steroids induce hyperglycemia; one should take careful consideration regarding the patient’s history of diabetes, blood sugar checks should be monitored closely while on steroids if the protocol is not already in place for diabetic management, along with the implementation of a sliding scale for Humalog to maintain therapeutic blood sugar levels. Antibiotic therapy is likely the cause for this patient experiencing nausea and vomiting; recommendations for ondansetron (Zofran) IV 8MG Q8 hours as needed, preferably thirty minutes prior to the administration of IV antibiotics. Lastly, since the patient cannot tolerate intake and experiencing nausea/vomiting, recommendations for gentle hydration would benefit the patient, continuous normal saline at 50 ML/HR until the patient can tolerate meals. Drug Treatments To Address The Patient’s Pathophysiology Discussion Paper
Education recommendations for assisting the patient with the management of pneumonia diagnosis are as follows. Adequate hydration and good pulmonary hygiene, such as deep breathing and coughing, are essential for patients with pneumonia (McCance & Huether, 2019). Encourage the patient to drink plenty of fluids and practice deep breathing techniques; use of the spirometer should be at least every hour; if the patient is watching television, advise practicing on commercial breaks. Antibiotic therapy such as Cephalosporins can promote clostridioides difficile (c.diff) infection and instruct patients to monitor and report increased/abnormal frequency, consistency, and odor of stools (Rosenthal & Burchum). Also, educate this patient that steroids can cause hyperglycemia; it is essential to monitor intake and be sure not to contribute to elevated blood sugar levels through diet consumption.
References
McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The Biologic Basis for Disease in
Adults and Children (8th ed.). St. Louis, MO: Mosby/Elsevier
Nadler, S. (2020). Evaluation and Treatment of Severe Community-Acquired Pneumonia in the
ICU. Critical Care Alert, 28(8). https://www.proquest.com/trade-journals/evaluation-Links to an external site.
treatment-severe-community-acquired/docview/2501269910/se-2
Rosenthal, L. D. & Burchum, J. R. (2021). Lehne’s Pharmacotherapeutics for Advanced
Practice Nurses and Physician Assistants (2nd ed.) St. Louis, MO: Elsevier Drug Treatments To Address The Patient’s Pathophysiology Discussion Paper
CLASS RESOURCES:
- Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants(2nd ed.) St. Louis, MO: Elsevier.
- Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 364–371)
- Chapter 47, “Drugs for Deficiency Anemias” (pp. 389–396)
- Chapter 50, “Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications” (pp. 425–436)
- Chapter 51, “Birth Control” (pp. 437–446)
- Chapter 52, “Androgens” (pp. 447–453)
- Chapter 53, “Male Sexual Dysfunction and Benign Prostatic Hyperplasia” (pp. 454–466)
- Chapter 70, “Basic Principles of Antimicrobial Therapy” (pp. 651–661)
- Chapter 71, “Drugs That Weaken the Bacterial Cell Wall I: Penicillins” (pp. 662–668)
- Chapter 75, “Sulfonamides Antibiotics and Trimethoprim” (pp. 688–694)
- Chapter 76, “Drug Therapy of Urinary Tract Infections” (pp. 695–699)
- Chapter 78, “Miscellaneous Antibacterial Drugs” (pp. 711–714)
- Chapter 79, “Antifungal Agents” (pp. 715–722)
- Chapter 80, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 723–743)
- Chapter 82, “Drug Therapy of Sexually Transmitted Diseases” (pp. 763–770)
- Roberts, H., & Hickey, M. (2016). Managing the menopause: An updateLinks to an external site.. Maturitas, 86(2016), 53–58. https://doi.org/10.1016/j.maturitas.2016.01.007
This article provides an update on treatments on Vasomotor symptoms (VMS), genito-urinary syndrome of menopause (GSM), sleep disturbance, sexual dysfunction, and mood disturbance that are common during the menopause transition. Drug Treatments To Address The Patient’s Pathophysiology Discussion Paper
Pharm WK 10 Discussion Response Post
Hi, I appreciate your detailed discussion on the 68-year-old who was admitted to the medical-surgical unit for community-acquired pneumonia. Community-based pneumonia is indeed associated with microorganisms such as streptococcus pneumonia, haemophilus influenzae, staphylococcus aureus, mycoplasma pneumoniae, chlamydia pneumoniae, moraxellacatarrhalis legionella pneumophila, Influenza, Rhinovirus, and Coronavirus (Wang et al., 2021). It is important to be careful when handling these microorganisms and their symptoms in order to determine the best treatment. Enough ventilation and oxygen supplement is, for real, the first step in handling this condition. Close monitoring of respiratory discomfort is important, considering the history of COPD. However, PRN orders for Oxygen 2L via nasal cannula for respiratory discomfort will be necessary. Indeed, this patient will also need an order for a spirometer, with instructions to utilize it at least every hour. Antibiotics and supportive therapy are crucial here to address symptoms the patient may experience, such as respiratory issues and nausea/vomiting. Both Azithromycin and Ceftriaxone are effective alternatives for Penicillin allergy patients. Azithromycin classifies as a macrolide while Ceftriaxone classifies as a cephalosporin, a broad-spectrum antibiotic categorized as a third-generation drug, making it highly effective against bacteria with good distribution, as you have discussed in this evaluation (Wang et al., 2021). Drug Treatments To Address The Patient’s Pathophysiology Discussion Paper
ORDER NOW
I do agree with you that a short-term, tapered dose of IV steroid treatment is recommended for respiratory inflammation; studies show that administering steroids decreases mortality rates and decreases hospital length of stay (Liu et al., 2021). Steroids induce hyperglycemia; one should take careful consideration regarding the patient’s history of diabetes, blood sugar checks should be monitored closely while on steroids if the protocol is not already in place for diabetic management, along with the implementation of a sliding scale for Humalog to maintain therapeutic blood sugar levels. Antibiotic therapy is likely the cause for this patient experiencing nausea and vomiting; recommendations for ondansetron (Zofran) IV 8MG Q8 hours as needed, preferably thirty minutes prior to the administration of IV antibiotics. Indeed, gentle hydration would benefit the patient, and continuous normal saline at 50 ML/HR until the patient can tolerate meals (Liu et al., 2021).
To add to the current drugs the patient is undertaking, her pathophysiology can also be managed using drugs like Levofloxacin, a fluoroquinolone antibiotic used to treat pneumonia associated with susceptible microorganisms (Wang et al., 2021). This drug effectively manages Haemophilus influenza and Streptococcus pneumoniae (Wang et al., 2021). It can also be used as an alternative for allergies associated with penicillin. Drug Treatments To Address The Patient’s Pathophysiology Discussion Paper