Pharm Week 7 Reorder Discussion Question 1
University:
SOUTH UNIVERSITY
Pharm Week 7 Reorder Discussion Question 1
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.
We Work Hard So That You Don’t
We’ll write a 100% plagiarism-free paper in under 1 hour.
Sample Answer
The patient has a grade I lateral ankle sprain characterized by mild tenderness, swelling, and slight functional loss. Pain control is vital for quality patient care. I would prescribe Acetaminophen (Tylenol) for pain relief. Tylenol would be the best choice since it is an analgesic and has sedating properties, which are helpful for patients who have sustained trauma or injuries and will promote patient comfort (Halabchi & Hassabi, 2020).
It is used as a single agent for mild to moderate pain, as in the patient scenario. Analgesics are recommended if a patient has significant ecchymosis to prevent further hemorrhage into the injury site (Halabchi & Hassabi, 2020). Prescribing the patient an NSAID can result in increased swelling if the ecchymosis is due to platelet inhibition.
I would prescribe Acetaminophen at 1gm orally every 8 hours.
The patient will be cautioned against taking more than 3 gm of Acetaminophen per day due to the risk of hepatic impairment (Bacle et al., 2019). The patient will be informed of potential side effects of Acetaminophen, such as dizziness, disorientation, skin rash, angioedema, and urticaria (Bacle et al., 2019). Besides, I would advise the patient to discontinue the drug immediately and report if he develops allergic symptoms or hypersensitivity reactions.
The patient’s age determined the dose of Acetaminophen. The patient is likely to have a good clearance based on his age and medical history. If he were an elderly patient, 80 years and older, a lower dose would have been prescribed. According to Bacle et al. (2019), increasing age and frailty have been associated with reduced clearance of Tylenol, leading to higher Tylenol plasma concentrations. The high plasma concentration in older patients can result in hepatotoxicity.
References
- Bacle, A., Pronier, C., Gilardi, H., Polard, E., Potin, S., & Scailteux, L. M. (2019). Hepatotoxicity risk factors and acetaminophen dose adjustment, do prescribers give this issue adequate consideration? A French university hospital study. European journal of clinical pharmacology, 75(8), 1143-1151. http //dx.doi.org/10.1136/dtb.2018.6.0636
- Halabchi, F., & Hassabi, M. (2020). Acute ankle sprain in athletes Clinical aspects and algorithmic approach. World journal of orthopedics, 11(12), 534–558. https //doi.org/10.5312/wjo.v11.i12.534
We Work Hard So That You Don’t
We’ll write a 100% plagiarism-free paper in under 1 hour