Jana, a 36-year-old single mother of three children, has a 15-year history of asthma. For the past month, she has been using albuterol every day. Previously, she had been using the inhaler every 3 to 4 months. She is in the office for a refill. What further information is needed to treat this patient and why? What clinical guidelines should you refer to for her medication management and why? 

Dave is a 47-year-old male patient in for a follow-up visit to discuss his chronic allergic rhinitis and nasal congestion. He takes Claritin 10mg daily which seems to help his clear runny nose and itchy eyes. However, he complains of chronic nasal congestion and difficulty breathing through his nose. You find out he has been using over-the-counter Afrin nasal spray twice a day for several months. What do you think is contributing to his chronic nasal congestion? How would you manage this patient going forward?   

Lester is a 67-year-old male who is prescribed Warfarin for his new onset atrial fibrillation. He is concerned about starting this medication and admits he is forgetful about taking meds and doesn’t understand why he must have follow-up blood tests. Discuss the patient education you would offer about Warfarin (include side effects). How would you address his concerns and questions? How can you ensure your patient education information is accurate and up to date? Are there other medications that you could consider for Lester? 

Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas. In your peer replies, please reply to at least one peer who chose a different topic