Sarah Johnson is a 32-year-old pregnant female at 24 weeks gestation

When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.Review assignment rubric and case studies. Be sure to thoroughly answer ALL questions.

• Explain the problem and discuss how you would address the problem.

• When recommending medications, write out a complete prescription for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, indication for use, quantity and # of refills. An example: lisinopril 10mg #30 tabs, take 1 tab PO once daily for high blood pressure, refills: 2.

• Also state if you would continue, discontinue or taper the patient’s current medications.

• Answer questions using your required learning resources, clinical practice guidelines, Medscape, etc.

• Include at least three references to support each scenario and cite them in APA format. Please include in-text citations. You do not need an introduction or conclusion paragraph.
SCENARIO 1

Sarah Johnson is a 32-year-old pregnant female at 24 weeks gestation. PMH consists of hypertension x 3 years and acne treated with isotretinoin and spironolactone 50 mg po daily. She denies smoking and alcohol but drinks 3 cups of coffee per day. Lisinopril 10mg daily was discontinued due to pregnancy. She presents for a routine prenatal visit. Labs include Hgb 12.8, HCT 39.9, K 4.7, glucose 78, BUN 12, Cr 0.78. Her blood pressure is 150/95 mmHg, measured twice with a 5-minute interval. What treatment plan would you implement for Sarah? How would you treat her hypertension (include a complete medication order)? How would you monitor drug therapy and what is her goal blood pressure?

SCENARIO 2

Lydia is a 24-year-old single female presenting with vaginal discharge for 1 week. She is sexually active and has had unprotected sex with a new male partner for the last month. Her gonorrhea culture is positive. This patient is allergic to sulfa drugs. What is the first line treatment for this patient? What other organism should you consider covering and why? What medication would you prescribe to cover this organism (include complete medication orders)? How long should Lydia abstain from sexual activity to prevent reinfection? What patient education would you provide?

SCENARIO 3

Edgar is a 6-year-old boy seen in the clinic today. His mother states he woke up this morning with his right eye red and swollen with a crusty yellow discharge. He has been diagnosed with bacterial conjunctivitis of the right eye. The mother asks if this is the same as “pink eye”? Edgar is allergic to sulfa drugs, amoxicillin and penicillin. His current medications include montelukast 10mg chewable tablet qhs. What treatment plan would you implement for Edgar (include complete medication orders)? What education would you provide to the patient’s mother regarding his treatment?

SCENARIO 4

JT is a 3-year-old male that was seen 3 days ago for acute otitis media. He weights 15 kg. Utilizing the dosage calculator in Medscape, write a prescription for liquid amoxicillin. If the patient develops a rash and is presumed to have an allergy, what alternative antibiotic would you prescribe to treat his acute otitis media? What education would you provide his mother during this visit?

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