Medical Surgical I: Pharmacology
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1. Mrs. T. calls the pediatrician’s office and asks whether she should give acetaminophen, aspirin, or ibuprofen to her child for a fever. Her son is 3 years old and weighs 40 lb. What should you suggest for her son, and what dosage?
2. Mr. Z. is starting therapy for gout and is now taking allopurinol. Discuss the teaching needs for this disease and medication, including dietary guidelines.
3. Rheumatoid arthritis has been diagnosed in Mrs. S., and she will be taking an NSAID as part of her therapy. What should be assessed before she starts this type of medication?
4. Mr. R. comes to the clinic complaining of hearing problems. He says he hears a “funny noise” all the time. During the assessment and history, you discover that he has been taking aspirin for joint pain for about 2 weeks. He cannot tell you how much but says he takes “three or four pills three or four times a day.” What is the proper dosage for aspirin? Is Mr. R. showing signs and symptoms of aspirin toxicity?
5. Mrs. R. calls the clinic to ask about her medications. She wants to use an OTC pain reliever for headaches, but she remembered that she needed to check with her physician because she is taking an oral anticoagulant. She has acetaminophen, ibuprofen, and aspirin products at home. What should you tell her?
Case Scenario
A.R. is a 66-year-old male patient who comes to the clinic today with complaints of a painful big toe. Upon examination, the nurse notes that the toe is very red and swollen at the joint. A.R. advises the nurse not to touch his toe because it hurts so badly that he “cannot even wear a sock.” The nurse notes a significant decrease in the mobility of the big toe as well. A.R. has a history of ulcers, and the nurse notes that he consumes “several” alcoholic beverages each day. The physician sends A.R. to the laboratory for a uric acid level, and the results demonstrate a significant elevation. The physician makes a diagnosis of gouty arthritis and gives A.R. a prescription for febuxostat (Uloric) and colchicine.
What is the mechanism of action of colchicine, and how will this drug help A.R.?
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What is the mechanism of action of febuxostat, and how will this drug help A.R.?
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What side effects of febuxostat will the nurse teach the patient about?
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