Question

CASE STUDY

Tina Bremmer is a 20-year-old college student with moderate persistent asthma. She has a cold. While dashing across the campus on a cold fall day, she suffers an asthma attack. Her girlfriend, who is with her, knows that Tina keeps her medication in her backpack. She opens Tina’s pack, finds the inhaler, and gives it to her. Tina uses the inhaler, but instead of achieving relief, she goes into bronchospasm. She is taken to the Emergency Department of the nearest hospital.

Data Obtained From ED Assessment

• Lungs sounds have bilateral wheezes, with diminished sounds at bases
• Pulse oximetry 90% on admission to the ED
• Other physical assessment normal
• Vital signs: Temperature, 97.7°F; pulse, 110; respirations, 26 and shallow; blood pressure, 120/86 prior to nebulizer treatment in the ED

Current Drug Therapy

• Ipatropium inhaler( Atrovent) two puffs four times daily
• Budesomide (Pulmicort) inhaler two puffs twice daily
• Albuterol inhaler two puffs q4h prn

CONSIDER THE CORE DRUG KNOWLEDGE FOR THIS DRUG:

Provide the following information for each drug that the patient is taking:

Be sure to provide information that is specific to this patient

Action, Indication for use, Therapeutic dosage, Contraindications, Adverse Reactions

Any Drug/Drug Interaction with her current medications

CONSIDER THE CORE PATIENT VARIABLES FOR THIS DRUG:

( consider the patient history including past medical history, social history, lifestyle etc.)

What patient variables are most important to consider for Tina when assessing her?

CONSIDER THE MANAGEMENT NEEDED WITH THIS DRUG THERAPY

What actions are indicated to maximize therapeutic effects and minimize adverse effects given the patient’s condition from the ED assessment?

Answer 1

solution:- The current drug therapy of Patient are : O ipratropium inhaler :- nctions of is an anticholinergić agent. it will prevent the increase in intracellular concentration of cat, which is the action of Acetyl choline on smooth made Indication :- ATROVENT nhalation is used in treating beenchosperm ~ due to cops, bronchitis and emphysema. Therapeutic dosage in starting dose= a inhalations & times aday - Additional puffs can be taken, but not exceed 12 in 24 hours contraindicadors : Hyposensitives patients is contraindicahof - cAlso hypersensitive to atropine patients) og interactions & Additive interaction with concominantly used oths mli anticholinergie medicators Adverse doy reactions Headache, dry mouth, hoossness, cough and stuffy nose, chills are some of the ADRE. ® Budesconde whaler Actions of is a glucocorticosteroid dong, se, a polent and int a t will prevent the hyper activity esperm of the aroung causing asthma. Indication in Treatement and prophylaxis of asthma. ~ (Also used in inflammatory disease like crohns qulceratis hosapudo dosage : Initial dose - 360 mg - oral aholaden, twice a day (Foo Flozhalos witlmantanance dose - can merose close in 1-2 woorde nne maximum dose uph 720 meg twice aday. anmou colits

contraindicadore in patients with tuberculosis Herpes simples aye infachen Diabetes and intestinal infectione. Advere day reactors in Thinning & skin, acne problems, Tiredness etc Dog - Drug infractions :- cyp3 aa inhibitor Chelo cononde) cause a eight fold incose in budesonda exposne no other in Libidas like erythromyon, ritonavir el I can also nonse budesonido concentration. albukrol whalaton It is a smooth muscle relaxant of airways. i terrorist or wil actranke n It will activak Bi adrenergic readphon in the lungs causing bronchodialaton , Indication & Treatment and prevention of bronchospasm with reversible obstruehve airway dires. prevention of exercise induced bronchoppesm Dosage : a inhalatione repeated every 4-6 hours for aduthal yang h Fregent more inhalations - not recommended. contraindications: Hypersensitive to albuterol patients. Doug interactions: B-blockers not taken with albufars) assosol loop of thiazide dirates should not be pocom Albutsol - Digonin decreases 16-22% of digonn lovels. Advore any interachers at include headache, diarrees, cough i hoorsences, sore throat etc. ? Cs Scanned with CamScanner

No serious dong-drug inkraction with carrent thosep is Soen. As the patient is exposiencing cold with a temparature of (97.7°F), it should be monitored because of arge given to her like Albulerol and ipratropium can cause - chills, sunny nose and cough. patent should be informed not to take grape froute gjuice since it may interact with budesonide. » Hyper sensitivity with any of the given drug to the patent should be checked. ICS Scanned with CamScanner