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Example research essay topic: Pharmacology A Case Study In - 1,082 words

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... ion, neurotoxicity. Relevant interactions: None. Nursing considerations: Use cautiously in elderly patients and patients with cardiac disease.

Check renal, hepatic, and auditory function periodically during prolonged therapy. Drug should be discontinued if abnormalities occur. Applications to case study Piroxicam is an arthritis medication and is being used to treat Mrs A's osteoarthritis. The 20 mg dose is standard. Brody, T et al (1994: 397) does not recommend a time of day for taking the medication however scheduling with meals may reduce the drug's possible adverse reactions - which include epi gastric distress and peptic ulceration. Because epi gastric distress and peptic ulceration is another possible side effect of piroxicam, the patient needs to be monitored for these symptoms.

Mylanta suspension, 20 ml PRN The MIMS Annual (2000: 1 - 7) includes the following factors in its outline of Mylanta. Indications & amp; dosage: Liquid 10 to 20 ml three to four times daily, preferably between meals and at bedtime. Adverse reactions: Constipation or diarrhoea have rarely been reported with the use of Mylanta. Interactions: Concomitant use of antacid preparations may alter the absorption profiles of a wide variety of drugs.

Potential for adverse reaction with digoxin. Nursing considerations: Use cautiously in elderly patients. Record amount and consistency of stools. Warn patient not to take Mylanta indiscriminately or switch antacids without doctor's advice. Applications to case study Mylanta is possibly being used to treat the side effects of piroxicam - epi gastric distress and peptic ulceration.

If Mrs A has these symptoms, they could be managed with alternate medications such as Love or H 2 histamine receptor blockers and / or a regulated diet. Coloxyl 120 mg, 1 - 2 tablets at night The MIMS Annual (2000: 1 - 20) includes the following factors in its outline of Coloxyl. Indications & amp; dosage: Adults - two 120 mg tablets once a day after evening meal. Adverse reactions: Prolonged use may lead to diarrhoea, with excessive loss of water and electrolytes, particularly potassium. Nursing considerations: Should only be used occasionally. Don't use for more than 1 week without doctor's knowledge.

Applications to case study It cannot be determined from the case study any reason for Mrs A requiring a stool softener. If Mrs A is suffering from constipation, alternate treatments could be tried before resorting to medications. Diet can be managed to increase fibre levels and promote stool movements. The problems of poly pharmacy in Mrs A's case Gailbraith, A, Bullock, S & amp; Manias, E, (2001: 15) outlines the major symptoms of poly pharmacy and defines it as "the excessive and unnecessary use of medications." Elderly patients like Mrs A are particularly susceptible to this problem. Use of medications with no apparent indication Mrs A is taking drug therapy for conditions not diagnosed. The main example of this is her use of Coloxyl.

No reason is evident in the case study as to why she should require a stool softener. Use of duplicate medications Mrs A may be receiving duplicated medications for the same symptom. It is possible that paracetamol and piroxicam are both being used to treat the same symptoms of her osteoarthritis. There is no apparent reason given in the case study as to why she is taking paracetamol. Concurrent use of interacting medications There are several examples of this in Mrs A's case. The most noticeable is her use of furosemide with digoxin.

Frusemide is known to increase digoxin sensitivity. Use of contraindicated medications Medications taken that are not appropriate to a particular condition can result in aggravation of other existing conditions. Mrs A's use of Coloxyl could further aggravate the gastric upset that can be a side effect of furosemide, digoxin and piroxicam use. Use of inappropriate dosage Mrs A is receiving an excessive dose if digoxin.

This is causing symptoms of digoxin poisoning. Use of drug therapy to treat adverse drug reactions Mrs A's treatment also falls into this category. She is most likely being treated with Mylanta suspension to alleviate epi gastric distress / peptic ulceration caused by piroxicam. Assessment, management & amp; educational strategies that would have improved the outcome for Mrs A Application of the clinical decision making process would have prevented the poly pharmacy problems faced by the patient. Loeb, S. 2001 (2001: 22 - 26) outlines the 5 steps of the clinical decision making process: Assessment The nurse focuses on direct data collected by: Obtaining drug history Reviewing Mrs A's previous medical history (including physical, psychosocial and emotional status) Performing a physical examination Obtaining relevant laboratory or diagnostic test results Formulating a nursing diagnosis Using information gathered during assessment, define any potential or actual drug-related problems.

The most common statements related to drug therapy are "Knowledge deficit", "Noncompliance" and "Alteration in Health Maintenance." Planning Planning should ensure Mrs A's needs are being met - including nutrition and hygiene; that her condition is being monitored, and that tests are being carried out as ordered. Intervention/Education After developing the outcome criteria, the nurse determines the interventions needed to help Mrs A reach the desired behaviour and goals. Drug related interventions may focus on education strategies about a drug's action, adverse effects, scheduling, steps to avoid, treating drug reaction, as well as drug administration techniques - including compliance. Evaluation This is a systematic process for determining the effectiveness of nursing care. In regards to Mrs A's case, this would entail monitoring of observations and tests to determine their effectiveness and the evaluation of any adverse effects. Conclusion The patient's pharmacological management seems problematic and needs to be analysed.

This analysis needs to take into account the main problems of poly pharmacy - such as use of medications with no apparent indication, concurrent use of interacting medications and use of inappropriate dosage. It can thus be revealed that implementation of assessment / management and educational strategies - like the Clinical Decision Making Process, would significantly improve the outcome for Mrs A. Reference List Brody, T et al Ed 1994, Human Pharmacology. St Louis: Mosby Gailbraith, A, Bullock, S & amp; Manias, E, Ed 2001, Fundamentals of Pharmacology.

A textbook for nurses and allied health professionals. Australia: Addison-Wesley Loeb, S. 2001, Nursing 2001 Drug Handbook. Pennsylvania: Springhouse Corporation Local, S, Spratto, G & amp; Woods, A, Ed 1994, The Nurse's Drug Handbook. Delaware: Delmar Publishers Inc.

McKenry, L & amp; Salerno, E, Ed 1989, Mosby's Pharmacology in Nursing St Louis: The C. V. Mosby Company MIMS Annual 2000 Ed 24. Sydney: Medi Media Australia My Doctor web


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