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Posted: March 2nd, 2022
Post your answers to the 6 questions corresponding to this week’s content on primary care medication management.
Post your answers to the 6 questions corresponding to this week’s content on primary care medication administration. Present your responses and rationales. Help your rationales with high-level proof. (See Post Expectations)
A 70-year-old girl is in your workplace complaining of lately having hassle sustaining her stability after taking diazepam (valium). She sometimes takes diazepam when she feels anxious and has hassle sleeping. She has a 15-year historical past of taking diazepam.
Q1. Clarify the explanation for this affected person’s issue in sustaining her stability?
Q2. Diazepam experiences a big first-pass impact. What’s the first-pass impact, and the way can first-pass metabolism be circumvented?
A 75-year-old girl develops signs of a chilly and buys an over-the-counter chilly medication at the grocery retailer. The medication incorporates diphenhydramine, acetaminophen, and phenylephrine. She takes the advisable grownup dose however quickly after taking the medication she turns into very confused and disoriented.
Q3. What is probably going inflicting the indicators of confusion?
A 26-year-old girl who has by no means been pregnant is looking for preconception care as she is planning to pursue being pregnant in a few months. At present, she has no signs to report and on assessment of physique methods, there have been no considerations. Her previous medical historical past is critical for a historical past of rheumatic fever as a baby. She subsequently underwent valve alternative with a mechanical coronary heart valve. She is adopted by a heart specialist who has already evaluated her cardiac operate and she or he has acquired clearance from her heart specialist to pursue being pregnant. Information from her heart specialist embrace a latest cardiac echocardiography report that reveals a standard ejection fraction indicating regular cardiac operate.
She has no alterations in her every day actions associated to her coronary heart. She has no different significant medical or surgical historical past. She is a non-smoker, drinks sometimes however has stopped as she is making an attempt to conceive, and doesn’t use any non-prescription medicine.
Present Medicines: Her present medicines embrace solely prenatal nutritional vitamins, which she has begun in anticipation of being pregnant, and warfarin. She has no recognized drug allergy symptoms.
Very important Indicators: On examination, her pulse is 80 beats per minute, blood stress is 115/70 mm Hg, respiratory charge is 18 breaths per minute, and she or he is afebrile.
Measurements: Weight = 152 kilos, Peak = 5′5 ″, BMI= 25.29
This fall. How is warfarin metabolized? Does warfarin cross the placental barrier?
Q5. Clarify the hepatic drug metabolism of kids 1 12 months and older. How do they evaluate with the hepatic drug metabolism of infants and adults?
Q6. Clarify protein binding in the neonate.
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