advanced pharmacology case study

Project description
Please choose 1 of the 2 case studies
Assignment
Instructions
You may choose either of the following two case studies. paper should be written as if it were a journal article, include an opening and closing paragraph, and be approximately three to 4 pages long. There must be a minimum of five recent (less than five years old) references that must be evidenced –based when possible. Points will be deducted for improper referencing and/or APA format.

CASE STUDY 1:
History of Present Illness:
Sally Smith is a 36-year old female with a history of asthma and GERD. She is a medical secretary and a single mother of two children. Today she states her asthma has been “acting up” and she has been up three or four nights during the past week using her albuterol inhaler. She also tells you that she started to take St. John’s Wort a couple of weeks ago because she was feeling depressed. She smokes a pack of cigarettes daily and would like to stop smoking. She denies recent respiratory infection, heartburn, suicidal or homicidal intention. She is allergic to aspirin and NSAIDS.
Current medications:
Albuterol inhaler prn
Loratadine 10 milligrams PO daily
Omeprazole, 20 milligrams, PO BID
St. John’s Wort, 1 tablet, PO daily
Yasmin

Physical exam:
Pleasant. Well-groomed female NAD. Hgt. 5’5”, Wgt: 152 lbs. 132/70, 92, 22, Oxygen sat 96 %. Frequent bronchospastic cough, + expiratory wheezing. Otherwise exam WNL.
1. Briefly discuss the pathophysiology of asthma, GERD, and depression. Be sure to discuss the aspects that are relevant to the pharmacodynamics of the drug used to treat each condition.
For the herbal preparation, describe the current research on:
a. Pharmacodynamics; include pharmacokinetics if relevant to pharmacodynamics – for example, active metabolites or limited GI absorption.
b. Efficacy at treating this condition.
c. Adverse effects, interactions and prescriber considerations
d. Discuss the potential risks and advantages in taking herbal preparations, including, but not limited to, the reasons that people might be interested in taking herbal preparations and what type of precautions they should be advised to take.

2. Explain the pharmacokinetics of each medication. Be thorough and specific.

3. Discuss possible adverse effects of these drugs and relevant drug-drug interactions for this patient that require monitoring. Pay particular attention to those adverse effects for which the patient is at increased risk, and to those adverse effects that are potentially serious.
4. Discuss prescriber considerations, appropriate diagnostic tests that should be assessed and relevant patient education for this patient, Explain rationales for your answers.

Case Study #2
History of Present Illness:
Mr. Brown is a 51 year old male with hypertension, coronary artery disease, Type 2 diabetes mellitus, and paroxysmal atrial fibrillation. He presents today for his 3-month follow-up asking for a flu shot and complaining of heartburn for which he has been taking cimetidine. He denies dizziness, chest discomfort, shortness of breath, dysnea on exertion, abdominal discomfort or other symptoms. He has no known allergies.
Current medications:
Simvastatin, 40 milligrams, PO, daily
Lisinopril, 40 milligrams, PO, daily.
Byetta 10 mcg SQ BID before meals
Warfarin, 5 milligrams PO daily
Cimetidine, 400 milligrams PO daily

Physical Exam:
Alert, pleasant male NAD. Hgt. 5’ 9”, Wgt. 184 lbs, 144/82, 68, 20. Exam WNL.

1. Briefly discuss the pathophysiology of paroxysmal atrial fibrillation and heartburn, and the physiology of influenza viruses. Be sure to discuss the aspects that are relevant to the pharmacodynamics of the drug used to treat each condition.

2. Explain the pharmacodynamics of each medication. Be thorough and specific.

3. Explain the pharmacokinetics of each medication. Be thorough and specific.

4. Discuss possible adverse effects of these drugs and relevant drug-drug interactions for this patient that require monitoring. Pay particular attention to those adverse effects for which the patient is at increased risk, and to those adverse effects that are potentially serious.

5. Discuss prescriber considerations, appropriate lab tests that should be assessed and relevant patient education for this patient. Explain rationales for your answers.