Pharmacologic Management of Musculoskeletal and Related Disorders – NURS-6521 Week 7 Assignment: Case Studies

Pharmacologic Management of Musculoskeletal and Related Disorders – NURS-6521 Week 7 Assignment: Case Studies

Pharmacologic Management of Musculoskeletal and Related Disorders

Pharmacologic management of musculoskeletal and related disorders, such as arthritis, rheumatoid arthritis (RA), gout, and chronic pain, requires an understanding of pharmacokinetics, pharmacodynamics, and individual patient factors. Factors such as genetics, age, comorbidities, diet, and concurrent medication use significantly influence drug metabolism and therapeutic response (Cox et al., 2025). The following scenarios evaluate drug therapy plans, identify prescription errors, and propose evidence-based treatment options following current clinical practice guidelines.

Scenario 1: Prescription Errors, Classifications, and Mechanisms of Action

Allopurinol 2 mg PO initially, followed by 0.6 mg one hour later for acute gout flare #3 0 RF

Error:
Incorrect dose and indication. Allopurinol is not used for acute gout attacks but for chronic urate-lowering therapy (Qurie et al., 2023).

Correct Prescription:

Allopurinol 100 mg PO daily; increase gradually every 2–4 weeks to achieve serum uric acid <6 mg/dL. Dispense #30, 1 refill . Mechanism of Action (MOA): Inhibits xanthine oxidase, decreasing uric acid synthesis (Aziz & Jamil, 2023). Classification: Xanthine oxidase inhibitor (urate-lowering therapy). Rationale : Initiated for chronic gout prevention per 2020 ACR Gout Guidelines (American College of Rheumatology, 2020). GET ASSIGNMENT HELP HERE Dextromethorphan/bupropion (Vraylar) 45 mg/105 mg ER tablet. Take 1 tablet PO QAM for 3 days, then 1 tablet PO BID #60 0 RF Error: Incorrect brand name; Vraylar is cariprazine, not dextromethorphan/bupropion. Correct Prescription: Dextromethorphan/bupropion (Auvelity) 45 mg/105 mg ER tablet; take 1 tablet PO twice daily. Dispense #60, 0 refills. MOA : Dextromethorphan/bupropion acts by combining NMDA receptor antagonism and sigma-1 receptor agonism from dextromethorphan with dopamine and norepinephrine reuptake inhibition from bupropion, resulting in enhanced monoaminergic and glutamatergic neurotransmission that improves mood regulation (McCarthy et al., 2023). Classification: Combination of an uncompetitive NMDA receptor antagonist and sigma-1 receptor agonist (dextromethorphan) with a norepinephrine-dopamine reuptake inhibitor (bupropion). In combination, used as an antidepressant. Rationale: Dextromethorphan/bupropion is used for acute major depressive disorder (MDD) following FDA-approved labeling. Trazadone 50 mg PO qhs #30 1 RF Error: Spelling error. Trazodone has been misspelled as “Trazadone”. Correct Prescription: Trazodone 50 mg PO at bedtime for sleep. Dispense #30, 1 refill. MOA: Trazodone primarily blocks 5-HT₂A receptors and inhibits the serotonin transporter (SERT), which increases serotonergic signaling in a way that improves mood and alleviates anxiety (Shin & Saadabadi, 2022). It also antagonizes α₁-adrenergic and H₁-histamine receptors, which contribute to its sedating and orthostatic-hypotension effects. Classification: Serotonin antagonist and reuptake inhibitor (SARI) antidepressant (Shin & Saadabadi, 2022). Lithium carbonate 300 mg PO TID #90 for the goal therapeutic range of 1–2 mEq/L Error: Toxic target range; therapeutic serum level should be 0.6–1.2 mEq/L. Correct Prescription: Lithium carbonate 300 mg PO TID; monitor serum lithium and renal function every 3 months. Dispense #90, 0 refills. MOA: Lithium carbonate modulates neurotransmitter signaling via inositol monophosphatase inhibition (Sakrajda & Rybakowski, 2025). Classification: Mood stabilizer. Fentanyl transdermal patch 25 mcg/hr Apply 1 patch topically every 72 hours. Rotate application site. #10 patches 1RF Error: Strength appropriate, but must specify opioid-naïve status (contraindicated). Should be reserved for opioid-tolerant patients. Correct Prescription: Fentanyl transdermal patch 25 mcg/hr; apply 1 patch topically every 72 hours. Rotate sites. For opioid-tolerant patients only. Dispense #10 patches, 1 refill. MOA: Fentanyl is a μ-opioid receptor agonist providing central analgesia (Rullo et al., 2024). Classification: Opioid analgesic (Schedule II controlled substance). Pharmacologic Management of Musculoskeletal and Related Disorders – NURS-6521 Week 7 Assignment: Case Studies Scenario 2: Buspirone Half-Life and Anxiolytic Prescriptions Buspirone has a half-life of 3 hours. If a patient takes 15 mg at 20:00, by 08:00 (12 hours later), four half-lives have passed (12 ÷ 3 = 4). The remaining amount = 15 × (½)^4 = 0.94 mg. Thus, the plasma concentration is approximately 0.94 mg. Three Commonly Prescribed Medications for Anxiety Buspirone (Buspar) Order: Buspirone 10 mg PO twice daily. Dispense #60, 1 refill. MOA: Partial agonist at serotonin 5-HT1A receptors (Wilson & Tripp, 2023). Side Effects: Dizziness, nausea, headache. Rationale: Non-benzodiazepine anxiolytic suitable for generalized anxiety disorder (GAD). Escitalopram (Lexapro) Order: Escitalopram 10 mg PO daily. Dispense #30, 1 refill. MOA: Selective serotonin reuptake inhibitor (SSRI) (Landy & Estevez, 2023). Side Effects: Nausea, sexual dysfunction, and insomnia. Rationale: First-line SSRI for GAD and panic disorder (DeGeorge et al., 2022). Sertraline (Zoloft) Order: Sertraline 50 mg PO daily. Dispense #30, 1 refill. MOA: SSRI that increases synaptic serotonin (Moncrieff et al., 2022). Side Effects: Gastrointestinal upset, insomnia, fatigue. Scenario 3: Pediatric ADHD Diagnosis and Management Diagnosis: Based on DSM-5-TR criteria, LB exhibits symptoms of inattention and hyperactivity consistent with Attention-Deficit/Hyperactivity Disorder (ADHD), combined type. First-Line Medication: Methylphenidate ER (Concerta) Order: Methylphenidate ER 18 mg PO every morning. Dispense #30, 0 refills. MOA: Inhibits dopamine and norepinephrine reuptake in the CNS, enhancing attention and focus (Verghese & Abdijadid, 2024). Monitoring: Weight, appetite, BP, HR, sleep, and behavioral changes (Wolraich et al., 2020). Rationale: Stimulants like methylphenidate are first-line per AAP and NICE guidelines, with 70–80% efficacy in school-aged children (American Academy of Pediatrics, 2020). Scenario 4: Polypharmacy, Assessment, and Medication Optimization Current Medications: Metformin, Jentadueto (linagliptin/metformin), fluoxetine, amitriptyline, valacyclovir, gabapentin. Assessment: Duplication: Metformin and Jentadueto both contain metformin, which is a risk for lactic acidosis (Dyatlova et al., 2022). CNS depressants (amitriptyline + gabapentin + fluoxetine) raise fall and sedation risk (van Poelgeest et al., 2021). Unknown labs (A1c, renal, hepatic function) impede safe refills. Plan: Discontinue standalone metformin (duplicate therapy). Continue Jentadueto 2.5/1000 mg PO BID for diabetes. Reassess amitriptyline use; it may contribute to fatigue. Consider taper and switch to duloxetine if needed for neuropathic pain (Catalisano et al., 2024). Order labs: CBC, CMP, A1c, eGFR, LFTs, BP, and EKG. Possible disease states: Diabetes, depression, neuropathic pain, viral infection (Herpes Simplex Virus), and anxiety/insomnia. Conclusion Safe pharmacologic management requires attention to dosage accuracy, therapeutic duplication, pharmacodynamics, and individualized factors such as comorbidities and concurrent medications. Clinical decision-making should align with updated guidelines to ensure safety and efficacy across age groups and disease states. References American Academy of Pediatrics. (2020). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics , 144 (4), 1–25. https://doi.org/10.1542/peds.2019-2528 American College of Rheumatology. (2020). Gout clinical practice guidelines . Rheumatology.org. https://rheumatology.org/gout-guideline Aziz, N., & Jamil, R. T. (2023, July 25). Biochemistry, xanthine oxidase . PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK545245/ Catalisano, G., Campione, G. M., Spurio, G., Galvano, A. N., di Villalba, C. P., Giarratano, A., Alongi, A., Ippolito, M., & Cortegiani, A. (2024). Neuropathic pain, antidepressant drugs, and inflammation: A narrative review. Journal of Anesthesia, Analgesia and Critical Care , 4 (1). https://doi.org/10.1186/s44158-024-00204-z Cox, N., Mallen, C. D., & Scott, I. C. (2025). Pharmacological pain management in patients with rheumatoid arthritis: A narrative literature review. BMC Medicine , 23 (1). https://doi.org/10.1186/s12916-025-03870-0 DeGeorge, K. C., Grover, M., & Streeter, G. S. (2022). Generalized anxiety disorder and panic disorder in adults. American Family Physician , 106 (2), 157–164. https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html Dyatlova, N., Tobarran, N. V., Kannan, L., North, R., & Wills, B. K. (2022). Metformin-associated lactic acidosis (MALA) . PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK580485/ Landy, K., & Estevez, R. (2023). Escitalopram . PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557734/ McCarthy, B., Bunn, H., Santalucia, M., Wilmouth, C., Muzyk, A., & Smith, C. M. (2023). Dextromethorphan-bupropion (Auvelity) for the treatment of major depressive disorder. Clinical Psychopharmacology and Neuroscience , 21 (4), 609–616. https://doi.org/10.9758/cpn.23.1081 Moncrieff, J., Cooper, R. E., Stockmann, T., Amendola, S., Hengartner, M. P., & Horowitz, M. A. (2022). The serotonin theory of depression: A systematic umbrella review of the evidence. Molecular Psychiatry , 28 (3243–3256), 1–14. https://doi.org/10.1038/s41380-022-01661-0 Qurie, A., Bansal, P., Goyal, A., & Musa, R. (2023, December 26). Allopurinol . National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499942/ Rullo, L., Morosini, C., Lacorte, A., Cristani, M., Coluzzi, F., Candeletti, S., & Romualdi, P. (2024). Opioid system and related ligands: From the past to future perspectives. Journal of Anesthesia, Analgesia and Critical Care , 4 (1). https://doi.org/10.1186/s44158-024-00201-2 Sakrajda, K., & Rybakowski, J. K. (2025). The mechanisms of Lithium action: The old and new findings. Pharmaceuticals , 18 (4), 467. https://doi.org/10.3390/ph18040467 Shin, J. J., & Saadabadi, A. (2022). Trazodone . PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470560/ van Poelgeest, E. P., Pronk, A. C., Rhebergen, D., & van der Velde, N. (2021). Depression, antidepressants, and fall risk: Therapeutic dilemmas—A clinical review. European Geriatric Medicine , 12 (3), 585–596. https://doi.org/10.1007/s41999-021-00475-7 Verghese, C., & Abdijadid, S. (2024, October 29). Methylphenidate . Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482451/ Wilson, T. K., & Tripp, J. (2023). Buspirone . PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK531477/ Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R., Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., & Zurhellen, W. (2020). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics , 144 (4), 1–25. https://doi.org/10.1542/peds.2019-2528   Pharmacologic Management of Musculoskeletal and Related Disorders – NURS-6521 Week 7 Assignment: Case Studies Case studies are a useful way for you to apply your knowledge of pharmacokinetics and pharmacodynamic aspects of pharmacology to specific patient cases and health histories. For this Assignment, you evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis. Resources   Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources. WEEKLY RESOURCES To Prepare: Review the case study posted in “Announcements” by your Instructor for this Assignment Review the information provided and answer questions posed in the case study When recommending a medication, write out a complete prescription for the medication Whenever possible, use clinical practice guidelines in developing your answers when possible Include at least three references to support your answer and cite them in APA format. By Day 7 of Week 7 Submit the Assignment. submission information Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the  Turnitin Drafts  from the  Start Here  area. To submit your completed assignment, save your Assignment as  WK7Assgn_LastName_Firstinitial Then, click on  Start Assignment  near the top of the page. Next, click on  Upload File  and select  Submit Assignment  for review. Rubric NURS_6521_Week7_Assignment_Rubric NURS_6521_Week7_Assignment_Rubric Criteria Ratings Pts This criterion is linked to a Learning Outcome Scenario 1: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection. 15   to >
11.0
 pts
Excellent
Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.

11
 
to >
7.0
 pts
Good
Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.

7
 
to >
3.0
 pts
Fair
Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.

3
 
to >
0
 pts
Poor
Medication selected is inappropriate or would not be provided based on patient unique characteristics.

15
 pts

This criterion is linked to a Learning Outcome
Scenario 1: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

3
 pts
Complete
Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

0
 pts
Poor
The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.

3
 pts

This criterion is linked to a Learning Outcome
Scenario 1: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Pharmacologic Management of Musculoskeletal and Related Disorders – NURS-6521 Week 7 Assignment: Case Studies

4
 pts
Excellent
References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.

3
 pts
Good
References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.

2
 pts
Fair
References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.

0
 pts
Poor
No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.

4
 pts

This criterion is linked to a Learning Outcome
Scenario 1: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

3
 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.

2
 pts
Good
Contains a few (1 or 2) grammar, spelling, and punctuation errors.

1
 pts
Fair
Contains several (3 or 4) grammar, spelling, and punctuation errors.

0
 pts
Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

3
 pts

This criterion is linked to a Learning Outcome
Scenario 2: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.

15
 
to >
11.0
 pts
Excellent
Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.

11
 
to >
7.0
 pts
Good
Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.

7
 
to >
3.0
 pts
Fair
Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.

3
 
to >
0
 pts
Poor
Medication selected is inappropriate or would not be provided based on patient unique characteristics.

15
 pts

This criterion is linked to a Learning Outcome
Scenario 2: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

3
 pts
Complete
Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

0
 pts
Poor
The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.

3
 pts

This criterion is linked to a Learning Outcome
Scenario 2: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.

4
 pts
Excellent
References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.

3
 pts
Good
References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.

2
 pts
Fair
References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.

0
 pts
Poor
No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.

4
 pts

This criterion is linked to a Learning Outcome
Scenario 2: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

3
 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.

2
 pts
Good
Contains a few (1 or 2) grammar, spelling, and punctuation errors.

1
 pts
Fair
Contains several (3 or 4) grammar, spelling, and punctuation errors.

0
 pts
Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

3
 pts

This criterion is linked to a Learning Outcome
Scenario 3: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.

15
 
to >
11.0
 pts
Excellent
Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.

11
 
to >
7.0
 pts
Good
Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.

7
 
to >
3.0
 pts
Fair
Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.

3
 
to >
0
 pts
Poor
Medication selected is inappropriate or would not be provided based on patient unique characteristics.

15
 pts

This criterion is linked to a Learning Outcome
Scenario 3: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

3
 pts
Complete
Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

0
 pts
Poor
The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.

3
 pts

This criterion is linked to a Learning Outcome
Scenario 3: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.

4
 pts
Excellent
References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.

3
 pts
Good
References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.

2
 pts
Fair
References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.

0
 pts
Poor
No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.

4
 pts

This criterion is linked to a Learning Outcome
Scenario 3: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

3
 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.

2
 pts
Good
Contains a few (1 or 2) grammar, spelling, and punctuation errors.

1
 pts
Fair
Contains several (3 or 4) grammar, spelling, and punctuation errors.

0
 pts
Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

3
 pts

This criterion is linked to a Learning Outcome
Scenario 4: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.

15
 
to >
11.0
 pts
Excellent
Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.

11
 
to >
7.0
 pts
Good
Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.

7
 
to >
3.0
 pts
Fair
Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.

3
 
to >
0
 pts
Poor
Medication selected is inappropriate or would not be provided based on patient unique characteristics.

15
 pts

This criterion is linked to a Learning Outcome
Scenario 4: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate. Pharmacologic Management of Musculoskeletal and Related Disorders – NURS-6521 Week 7 Assignment: Case Studies

3
 pts
Complete
Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

0
 pts
Poor
The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.

3
 pts

This criterion is linked to a Learning Outcome
Scenario 4: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.

4
 pts
Excellent
References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.

3
 pts
Good
References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.

2
 pts
Fair
References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.

0
 pts
Poor
No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.

4
 pts

This criterion is linked to a Learning Outcome
Scenario 4: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

3
 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.

2
 pts
Good
Contains a few (1 or 2) grammar, spelling, and punctuation errors.

1
 pts
Fair
Contains several (3 or 4) grammar, spelling, and punctuation errors.

0
 pts
Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

3
 pts

Total Points: 
100

Pharmacologic Management of Musculoskeletal and Related Disorders – NURS-6521 Week 7 Assignment: Case Studies

Case studies are a useful way for you to apply your knowledge of pharmacokinetic and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.

For your week 7 assignment, evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.

Directions:
 
For each of the scenarios below, answer the questions using your required learning resources, Medscape, and clinical practice guidelines (ie AHA, ACC, ADA). When recommending medications, write out a 
complete prescription
 for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, special instructions, # dispensed (days supply), refills etc. Also state if you would continue, discontinue or taper the patient’s current medications (if applicable). Use 
at least 3 sources
 for 
each scenario
 and cite sources using APA format.

WEEK 7 ASSIGNMENT (covers weeks 7-8)

SCENARIO 1

What are the errors in the following prescriptions (5 total)? Rewrite each prescription correctly. What is each medication classification? What is the mechanism of action (MOA)?

allopurinol 2 mg PO initially, followed by 0.6 mg one hour later for acute gout flare #3 0 RF

dextromethorphan/bupropion (Vraylar) 45 mg/105 mg extended-release tablet Take 1 tablet PO QAM for 3 days, then 1 tablet PO BID #60 0RF

trazadone 50 mg po qhs #30 1 RF

lithium carbonate 300 mg po TID #90 for goal therapeutic range of 1-2 mEq/L

fentanyl transdermal patch 25 mcg/hr Apply 1 patch topically every 72 hours. Rotate application site. #10 patches 1RF

 

SCENARIO 2

Buspirone has a 
half-life
 of 3 hours. If a patient takes 15 mg at 20:00, what will the blood level (mg) be at 8 am? Name 
3 medications
 you might prescribe for a patient with 
anxiety
. Include complete medication orders, MOA and common side effects for each of the 3 medications.

 

SCENARIO 3

LB is an 8-year-old male brought in by his mother due to concerns about behavior and school performance. His teacher reports that LB is frequently out of his seat, talks excessively, blurts out answers, and has difficulty completing tasks or following multi-step directions. At home, he often loses toys and homework, seems forgetful, and struggles to stay focused on activities like reading. He has no significant medical history. Growth and development are age-appropriate. He sleeps about 9 hours per night but still wakes up feeling tired. His diet is average for a child his age. There are no signs of anxiety, depression, or other mood disorders. What is the 
most likely 
diagnosis
? What is an appropriate 
first-line medication
 (include complete medication order)? What 
monitoring parameters
 should be considered during treatment?

 

SCENARIO 4

ST is a 51-year-old male presenting for medication refills. He has no recent lab work, but reports fatigue and occasional dizziness. Current meds: metformin 1000 mg PO daily, Jentadueto 2.5 mg/1000 mg PO BID, fluoxetine 20 mg po daily, amitriptyline 50 mg PO qhs, valacyclovir 1 gram PO TID x 7 days, gabapentin 300 mg PO TID. He is unsure of his A1c or blood pressure. How would you assess and 
improve his regimen
? What monitoring is needed? List 
5 possible disease states
based on his medications. Pharmacologic Management of Musculoskeletal and Related Disorders – NURS-6521 Week 7 Assignment: Case Studies