Pharm Week 7 A 26-year-old, otherwise healthy male presents limping into the examination room, holding his right shoe in his hand
University:
SOUTH UNIVERSITY
Pharm Week 7 A 26-year-old, otherwise healthy male presents limping into the examination room, holding his right shoe in his hand
Paper Instructions
Tom, a 26-year-old runner, came into the office today complaining of constant pain in the right ankle. While running his usual route, he accidentally stepped on a branch lying in his path, twisting his ankle inward. He denies hearing a \”pop.\” He was able to walk, or limp, the remaining ¼ mile back to his home, where he immediately elevated and iced the ankle for 30 minutes. He took two acetaminophen 325 mg, showered and dressed for work, and drove to his place of employment. He continued to experience significant pain in the ankle, worse when walking.
His foot became swollen. Since his job in a sporting goods store requires that he be on his feet most of the day, he was unable to continue his normal workday, and made a same-day appointment to be seen. He has no chronic diseases, takes no medication, and denies recent use of NSAIDs, as aspirin and ibuprofen cause him to have gastritis. He sprained the ankle last year, but was able to manage that injury at home.
Assessment
A 26-year-old, otherwise healthy male presents limping into the examination room, holding his right shoe in his hand. He grimaces with partial weight-bearing of the affected foot. He has local ecchymosis and 1+ edema over the anterolateral ligaments of the right ankle. Capillary refill, pulses, and sensation of the foot and toes are intact. There is no lateral or anterior instability of the joint or tendons. X-ray of the ankle and foot are negative for fracture or dislocation. He has a grade I lateral ankle sprain.
- What pain relieving medications would you prescribe? Defend your choice.
- How would you prescribe them?
- What side effects should you educate the patient about?
- Does the age of the patient influence what your choice?
Discussion Question 2
What organs are damaged mostly by taking NSAIDS? What patient education would you provide to someone taking NSAIDS? What organ is damaged by taking too much aspirin? What patient education should you provide to a patient taking Aspirin? List 3 diagnosis for which you would administer NSAIDS. List 3 diagnosis for which you would administer Aspirin. What labs or diagnostic tests would you perform for a patient who has consumed too much Aspirin and NSAIDS. Your response should be at least 350 words.
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Sample Answer
Pharm week 7 Discussion 2
Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause significant end-organ damage, especially in the elderly. Body organs known to be damaged by NSAIDs include the brain, heart, respiratory tract, GI tract, liver, and kidneys. Damage to the brain results in intracerebral hemorrhage (Bindu et al., 2020).
Cardiovascular injury results in hypertension and heart failure. NSAID damage to the respiratory tract cause complications such as community-acquired pneumonia. The greatest damage of NSAIDs occurs in the GI tract, where they cause ulceration resulting in GI bleeding and ulcers (Bindu et al., 2020). NSAIDs cause Hepatocellular injury resulting in hepatotoxicity and renal injury in the kidneys.
Patient education for a patient on NSAIDs includes taking the drugs with food to prevent injury to the gastric mucosa. I would also advise a patient to avoid alcohol consumption when on NSAIDs since it increases the risk of GI ulceration and bleeding (Bindu et al., 2020). Besides, I would inform the patient of potential side effects such as dizziness, heartburn, epigastric pain, constipation, nausea, tinnitus, rash, edema, headache, and vomiting.
Aspirin overdose can result in organ damage of the GI tract, platelets, liver, and kidneys. Aspirin damages the GI mucosa resulting in GI bleeding (Li et al., 2020). It also irreversibly inhibits platelet function. Injury to the liver may cause liver dysfunction and to the kidneys renal failure.
Patient education for a patient on Aspirin includes avoiding alcohol consumption since it compounds the risk of GI bleeding (Li et al., 2020). I would also advise intake of adequate water since it can cause kidney damage if one is dehydrated.
I would administer NSAIDs for diagnoses such as migraines, arthritis, and gout. Aspirin would be administered for Osteoarthritis, Ischemic stroke, and Myocardial infarction.
Diagnostic tests for a patient who had an NSAID or Aspirin overdose include Livet Function Tests for liver damage, coagulation studies, Salicylate level, ABGs, lactate electrolytes, and Complete Blood Count (Li et al., 2020). A head CT scan will be requested if the patient is in an altered mental status. An electrocardiogram will be requested to rule out dysrhythmias.
References
- Bindu, S., Mazumder, S., & Bandyopadhyay, U. (2020). Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage A current perspective. Biochemical pharmacology, 180, 114147. https //doi.org/10.1016/j.bcp.2020.114147
- Li, Z., Wang, Z., Shen, B., Chen, C., Ding, X., & Song, H. (2020). Effects of aspirin on the gastrointestinal tract Pros vs. cons. Oncology Letters, 20(3), 2567-2578. https //doi.org/10.3892/ol.2020.11817
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