Interactive Upper Respiratory Case Study
Interactive Upper Respiratory Case Study
Jackieis a 45-year-old white female with past medical history of controlled hypertension, controlled asthma, and eczema. She has a four-day history of nasal congestion, headache, sore
throat, sneezing, and productive cough. She denies fever, nausea, vomiting, and myalgias. She has three children who recently went back to school following a summer vacation. No one else in her household is currently presenting with similar symptoms. She has no known drug allergies but is allergic to mums and ragweed. She calls her primary care provider’s office requesting a medication to treat her illness. She takes several medications, including the following:
• Mometasone 220 mcg—1 puff daily for asthma.
• Albuterol 90 mcg—1 to 2 puffs q4–6 hours as neededfor shortness of breath.
• Lisinopril 10 mg—one tablet by mouth daily forhypertension.
• Oxymetazoline hydrochloride 0.05% nasal spray—2sprays per nostril bid × 3 days.
Provide rationales for your answers:
1. Which of the following is the MOST appropriate drugto recommend?
a. Oxymetazoline hydrochloride 0.05% nasal spray—2 sprays per nostril bid until symptoms resolve.
b. Naproxen 220 mg—one tablet by mouth every12 hours as needed until symptoms resolve.
c. Dextromethorphan ER oral liquid—60 mg every12 hours until symptoms resolve.
d. Amoxicillin–clavulanic acid 500 mg every 8 hoursfor seven days.
2. Which of the following nonpharmacological therapiesis NOT recommended?
a. Steam inhalation
b. Increased water intake
c. Menthol lozenges
d. Saline gargle
3. Jackieis insistent on taking a complementary therapy tohelp treat her symptoms. What is the MOST appropriaterecommendation?
a. Echinacea purpurea tincture—0.75 mL
b. Fresh garlic—3 cloves
c. Acidophilus probiotic—1 tablet daily
d. Vitamin C—1 g
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