Part I: A Condition Or Medication Template Will Be Provided ✓ Solved

Part I: A condition/medication template will be provided. Fo

Part I: A condition/medication template will be provided. For each of the following conditions identify one medication to treat it and give full details on the provided template: Psoriasis; Thrush; Dystonia; Gout.

Part II: Answer the following questions:

1. Describe the risk factors for hypocalcemia.

2. Describe osteoporosis.

3. Describe the treatment for abnormal calcium levels.

4. Describe osteoarthritis and rheumatoid arthritis.

5. Describe the treatment for arthritis.

6. Describe gout, including its risk factors and treatment.

7. Describe the use of nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, disease-modifying antirheumatic drugs, and corticosteroids for bone and joint inflammation.

8. Describe phantom limb pain and its treatment.

Part III: Should kids with head lice be allowed at school?

Paper For Above Instructions

Introduction

This paper responds to the three parts of the assignment: (I) selection and detailed description of one medication for psoriasis, thrush (oral candidiasis), dystonia, and gout; (II) answers to eight focused musculoskeletal and metabolic questions including hypocalcemia, osteoporosis, arthritis, gout, pharmacologic classes for inflammatory joint disease, and phantom limb pain; and (III) an evidence-based position on school attendance for children with head lice.

Part I — Condition and Medication Templates

Psoriasis — Medication: Methotrexate

Drug class: Antimetabolite, disease-modifying antirheumatic drug (DMARD). Mechanism: Folate antagonist that suppresses DNA synthesis and reduces keratinocyte proliferation and immune activation (systemic immunomodulation) (Menter et al., 2019). Indications: Moderate to severe plaque psoriasis and psoriatic arthritis. Typical adult dosing: weekly oral or subcutaneous 7.5–25 mg once weekly with folic acid supplementation (1 mg daily or 5 mg weekly, per local guidance) (Menter et al., 2019). Major adverse effects: hepatotoxicity, myelosuppression, mucositis, pulmonary toxicity. Contraindications: pregnancy, severe hepatic or renal impairment, preexisting significant cytopenias. Monitoring: baseline CBC, LFTs, renal function, hepatitis B/C screen; periodic monitoring every 1–3 months (Menter et al., 2019). Patient education: avoid pregnancy during and for 3 months after therapy; report fever, sore throat, jaundice, or new cough.

Thrush (Oral Candidiasis) — Medication: Nystatin Oral Suspension

Drug class: Polyene antifungal. Mechanism: Binds ergosterol, increasing fungal cell membrane permeability and causing cell death (Pappas et al., 2016). Indications: Mild-moderate oral candidiasis. Dosing: Swish and swallow/spit 400,000–600,000 units four times daily until 48 hours after clinical resolution (IDSA guideline range). Adverse effects: uncommon; occasional GI upset, taste changes. Contraindications: hypersensitivity. Monitoring: clinical response; adjust in severe disease and immunocompromised patients, who may require systemic azoles (Pappas et al., 2016).

Dystonia — Medication: Botulinum Toxin Type A

Drug class: Neurotoxin. Mechanism: Inhibits presynaptic acetylcholine release at the neuromuscular junction, producing focal muscle relaxation (Albanese et al., 2013). Indications: Focal dystonias (cervical dystonia, blepharospasm, oromandibular dystonia). Dosing: Dose and injection sites individualized by muscle and severity; typically repeated every 3–4 months. Adverse effects: local weakness, dysphagia (when used in cervical/oromandibular areas), spread of toxin effects. Contraindications: active infection at injection site, hypersensitivity. Monitoring: clinical efficacy and side effects; adjust dose or muscles targeted (Albanese et al., 2013).

Gout — Medication: Allopurinol

Drug class: Xanthine oxidase inhibitor (urate-lowering therapy). Mechanism: Inhibits xanthine oxidase, reducing uric acid synthesis (FitzGerald et al., 2020). Indications: Chronic gout with recurrent flares, tophi, or uric acid nephrolithiasis. Dosing: Initiate low (100 mg daily) and titrate upward (usually to 300 mg daily; higher doses may be used with monitoring) to achieve serum urate

Part II — Answers to Specific Questions

1. Risk Factors for Hypocalcemia

Hypocalcemia results from decreased parathyroid hormone (PTH), vitamin D deficiency, or resistance, and calcium loss. Key risk factors include hypoparathyroidism (post-thyroidectomy), vitamin D deficiency (insufficient intake, malabsorption, limited sun exposure), chronic kidney disease (reduced 1-alpha hydroxylation), pancreatitis, sepsis, massive blood transfusion (citrate chelation), certain medications (bisphosphonates, loop diuretics in some contexts), and magnesium deficiency (impairs PTH secretion) (Bilezikian et al., 2016).

2. Describe Osteoporosis

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration, leading to increased fracture risk. Diagnosis is commonly made by dual-energy X-ray absorptiometry (DXA) with T-score ≤ −2.5 or by fracture with low trauma. Major risk factors include advanced age, female sex, postmenopausal estrogen deficiency, glucocorticoid use, low body weight, smoking, excessive alcohol, family history, and certain secondary causes (Compston et al., 2019).

3. Treatment for Abnormal Calcium Levels

Treatment depends on direction and cause. Hypocalcemia: acute symptomatic hypocalcemia requires intravenous calcium gluconate bolus followed by infusion, correction of hypomagnesemia, and vitamin D (calcitriol) or calcium supplementation for chronic cases (Bilezikian et al., 2016). Hypercalcemia management includes hydration, loop diuretics, bisphosphonates for malignancy-related hypercalcemia, calcitonin for short-term effect, and addressing underlying causes (malignancy, hyperparathyroidism) (Compston et al., 2019).

4. Osteoarthritis and Rheumatoid Arthritis

Osteoarthritis (OA) is a degenerative joint disease with cartilage loss, osteophytes, and subchondral changes, typically affecting weight-bearing joints and small hand joints; pain often worsens with use (Hunter & Bierma‑Zeinstra, 2019). Rheumatoid arthritis (RA) is an autoimmune inflammatory polyarthritis causing symmetric joint swelling, synovitis, pannus formation, systemic features, and erosive joint damage (Smolen et al., 2018).

5. Treatment for Arthritis

OA management focuses on nonpharmacologic measures (exercise, weight loss, physical therapy), analgesia (acetaminophen, topical NSAIDs), and joint injections or surgery when needed (Hunter & Bierma‑Zeinstra, 2019). RA treatment uses early disease‑modifying therapy: conventional synthetic DMARDs (methotrexate first-line), biologic DMARDs (TNF inhibitors, IL-6 inhibitors), and short courses of corticosteroids for flares (Smolen et al., 2018).

6. Gout: Risk Factors and Treatment

Gout risk factors include hyperuricemia from overproduction or underexcretion, male sex, older age, obesity, high-purine diet, alcohol (especially beer), diuretics, chronic kidney disease, and genetic predisposition (FitzGerald et al., 2020). Acute treatment: NSAIDs, colchicine, or corticosteroids to control inflammation. Long-term urate-lowering therapy: xanthine oxidase inhibitors (allopurinol, febuxostat) or uricosurics (probenecid) to maintain serum urate targets and prevent flares (FitzGerald et al., 2020).

7. Use of NSAIDs, COX-2 Inhibitors, DMARDs, and Corticosteroids

NSAIDs are effective analgesic and anti-inflammatory agents for acute musculoskeletal pain and gout flares but carry GI, renal, and cardiovascular risks. COX-2 inhibitors provide equivalent anti-inflammatory efficacy with lower GI bleeding risk but increased cardiovascular risk (depending on agent and patient factors). DMARDs (conventional and biologic) treat inflammatory arthritides by modifying disease course and preventing joint damage (methotrexate, TNF inhibitors) (Smolen et al., 2018). Corticosteroids rapidly suppress inflammation for acute flares or bridging therapy but have systemic adverse effects with chronic use (osteoporosis, hyperglycemia, infection risk) (Smolen et al., 2018).

8. Phantom Limb Pain and Its Treatment

Phantom limb pain is neuropathic pain perceived in a missing limb following amputation, believed to involve peripheral neuroma activity, spinal sensitization, and cortical reorganization. Management is multimodal: pharmacologic agents for neuropathic pain (gabapentinoids, SNRIs, TCAs), short-term opioids in select cases, regional techniques, mirror therapy and graded motor imagery to address cortical reorganization, and interventional approaches (nerve blocks, spinal cord stimulation) when refractory (Flor, 2002; Dworkin et al., 2007).

Part III — Should Children with Head Lice Be Allowed at School?

Guidance from the Centers for Disease Control and the American Academy of Pediatrics supports that children with live head lice should not be excluded from school and should not be sent home early from school; omission policies are unnecessary and counterproductive. Evidence shows head lice spread slowly, are not a public health hazard, and exclusion policies disrupt education and stigmatize families (CDC, AAP). Recommended practice: allow children to remain in class, educate families about treatment (topical permethrin or oral ivermectin in select settings) and encourage implementation of evidence-based treatment and routine detection at home rather than mandatory school exclusion (CDC, 2010; AAP statement). Therefore, children with head lice should be allowed at school while families arrange prompt treatment and follow-up measures to reduce transmission.

Conclusion

The selected medications for the four conditions reflect common first-line or specialty therapies with attention to mechanism, dosing, monitoring, and safety. The musculoskeletal and metabolic topics covered address key risk factors, pathophysiology, and evidence-based therapeutic approaches. Public health policy on head lice favors keeping children in school while providing timely family-centered treatment and education to minimize disruption and stigma (CDC; AAP).

References

• Menter A, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis. J Am Acad Dermatol. 2019.
• Pappas PG, Kauffman CA, Andes DR, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016.
• Albanese A, Bhatia K, Bressman SB, et al. Phenomenology and classification of dystonia: a consensus update. Mov Disord. 2013.
• FitzGerald JD, Dalbeth N, Mikuls T, et al. 2020 ACR guideline for the management of gout. Arthritis Rheumatol. 2020.
• Compston J, Cooper A, Cooper C, et al. Osteoporosis. Lancet. 2019;393(10169):364–376.
• Bilezikian JP, Brandi ML, Cusano NE, et al. Guidelines for the management of hypocalcemia: report of the European Calcified Tissue Society. Endocrine Reviews. 2016.
• Hunter DJ, Bierma‑Zeinstra S. Osteoarthritis. Lancet. 2019;393(10182):1745–1759.
• Smolen JS, Landewé RBM, Bijlsma JWJ, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological DMARDs: 2016 update. Ann Rheum Dis. 2018.
• Flor H. Phantom-limb pain: characteristics, causes, and treatment. Lancet Neurol. 2002;1(3):182–189.
• Centers for Disease Control and Prevention (CDC). Head lice information for schools. CDC website. https://www.cdc.gov/parasites/lice/head/index.html. Accessed 2020.