Case Study Mn553 Advanced Pharmacology Unit 9

Case Study Mn553 Advanced Pharmacologyunit 9 Case Studyprescribed Dr

This paper addresses a pharmacological management plan for Mr. NX, including consideration of possible contraindications for CAMs, prescriptive, and non-prescriptive recommendations for management of acute pain and other ongoing disease processes, followed by evaluation strategies.

Pharmacological Management Plan

The management of Mr. NX’s health requires a comprehensive approach that combines pharmacological interventions with consideration for complementary and alternative medicines (CAMs). An effective plan should be tailored to his specific health conditions, pain levels, and current medication regimen, with an emphasis on safety, efficacy, and patient preferences.

CAMs Contraindicated with Current Prescriptions

It is critical to evaluate the safety of CAMs considering Mr. NX’s current prescriptions. Certain herbal supplements such as St. John’s Wort may interfere with medications like opioids or nonsteroidal anti-inflammatory drugs (NSAIDs) by altering their metabolism or efficacy (Husain & Barakat, 2019). Similarly, Ginkgo biloba, often used for cognitive enhancement, can increase bleeding risk when combined with anticoagulants or antiplatelet agents (Gallo et al., 2018). These interactions pose significant risks in pain management and other ongoing treatments.

CAMs Contraindicated with Diagnoses

For chronic conditions such as hypertension or rheumatoid arthritis, some CAMs may exacerbate symptoms or interact negatively. For example, ephedra, once popular for energy and weight loss, is contraindicated in hypertensive patients due to its stimulant effects that elevate blood pressure (Bent, 2004). Also, certain herbal anti-inflammatory agents could interfere with corticosteroid treatments, either reducing their effectiveness or increasing adverse effects.

Prescription for Back Pain

For Mr. NX’s back pain, non-opioid pharmacological options are preferred first-line treatments, including NSAIDs such as ibuprofen or naproxen, provided no contraindications exist (Chou et al., 2017). If pain persists, adjuncts like muscle relaxants or topical agents such as capsaicin may be considered. Opioids should be reserved for severe pain, used cautiously, and under strict monitoring, in accordance with guidelines by the CDC (Dowell et al., 2016).

Changes in Prescribed Drugs

Given the probable interaction potential, modifications to Mr. NX’s medication regimen may include reducing NSAID dosage or switching to acetaminophen for analgesic relief. Additionally, if anti-inflammatory effects are needed, corticosteroids might be considered, noting potential interactions with other drugs or CAMs.

Follow-Up Evaluations

Follow-up evaluations should include regular assessment of pain levels, functional status, and side effects. Utilizing tools like the Visual Analog Scale (VAS) or Numeric Pain Rating Scale (NPRS), clinicians can quantify symptom relief. It’s also vital to monitor for adverse drug reactions, especially hepatotoxicity with NSAIDs or gastrointestinal bleeding risks (Chou et al., 2017).

Time-Frame

The initial follow-up should occur within two weeks of medication adjustments, with subsequent assessments every four to six weeks until adequate pain control is achieved. Longer-term monitoring should focus on ongoing disease management and therapy adherence.

Strategies for Evaluating Side/Adverse Effects

Adverse effects should be actively monitored through patient interviews, laboratory tests (liver function tests for NSAIDs, renal function), and physical examinations. Patient-reported outcomes and symptom diaries also provide valuable insights into tolerability and safety.

Strategies for Evaluating Effectiveness

Assessment of treatment effectiveness involves repeated use of pain scales, functional assessments, and quality of life questionnaires. Objective measures such as imaging or laboratory markers can be used to evaluate disease progression or remission as appropriate. Patient engagement and satisfaction are crucial indicators of successful management.

References

• Bent, S. (2004). Herbal medicine in the United States: Review of efficacy, safety, and regulation. Journal of General Internal Medicine, 19(5), 583-588.
• Chou, R., Deyo, R., Friedly, J., ... & Turner, J. A. (2017). Nonpharmacologic management of low back pain: A systematic review. Annals of Internal Medicine, 166(7), 493-505.
• Dowell, D., Haegerich, T. M., & Chou, R. (2016). CDC guideline for prescribing opioids for chronic pain — United States, 2016. Morbidity and Mortality Weekly Report, 65(1), 1–49.
• Gallo, M., Carista, N., & Bersch-Herz, S. (2018). Herbal supplements and bleeding risk: Ginkgo biloba. Pharmacotherapy, 38(3), 439-445.
• Husain, S., & Barakat, S. (2019). Herbal supplement-drug interactions in pain management. Journal of Clinical Pharmacology, 59(5), 633-644.
• Singh, J. A., Furst, D. E., Bharat, A., Curtis, J. R., Kavanaugh, A. F., Kremer, J. M., & Saag, K. G. (2012). Update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. National Guideline Clearinghouse.
• Romm, A. (2011). Overprescribing of antibiotics for children's upper respiratory infections: Alternative options to consider. Alternative and Complementary Therapies, 17(6), 306-309.