Clinical Pharmacology for Advanced Practice Nursing

Case study report Instructions

• Please see the attached for additional details about the case study assignment.  Note that instructor permission is required in advance to use artificial intelligence tools for this course/assignment.
• The format for the case study report is an APA-format paper (no abstract needed).  We give groups flexibility to organize their paper.  Most groups use sub-headers that address the various topics (e.g., Pharmacokinetics, Pharmacodynamics, Monitoring, etc)—but those are not mandatory.
• You don’t need to copy the original questions from the assignment (those questions are mainly a guide for topics to address in your paper).  To meet APA you will need to summarize the original case problem using a few complete sentences (copying text directly from the assignment description will not comply with APA due to abbreviations, fragmented phrases, etc).  Sometimes it is also helpful to your readers to include a very brief background of disease pathophysiology.
• There is a page limit of 14 pgs double spaced, not including the prescription(s) or references. Attach the prescription (s) as appendices
• Be sure to include a prescription with your case report (template Rx attached); this can be inserted within the report text or as an Appendix at the end of report.
• The case discussion should focus on the patient described –you do not need to discuss aspects that are irrelevant to the patient in the case.  (For example, do not discuss hypothetical drug interactions with warfarin, immunosuppressant drugs, etc. unless the patient is taking those drugs.)
• For references, generally use evidence-based, peer-reviewed, sources published within the last 5 years.  I will send one possible attachment as well
• For drug information, the most current source is usually a web-based electronic compendium that is frequently updated (e.g., Lexicomp or AHFS) or current approved prescribing information/label.
• For drug interactions, an electronic interaction analyzer tool is highly recommended (Lexicomp has this available and you can access Lexicomp on the library website).
• A textbook can be cited as a source, but another more current source should be included because sometimes books are out of date.

Case:

Ms. Abe is 44 yo African American female

PMHX:  Obesity, Hypertension

FH:

HTN: Mother

DMII: Father

CKD: Mother

Cancer-Lung: Father died at 70

Allergies:  NKDA

Meds:

Hydrochlorothiazide 25mg daily

OTC:

MVI most days

Aleve 220 mg twice daily as needed for knee pain

Claritin D twice daily as needed for allergies and sinus congestion

Soc Hx;

Married

Tobacco: 1-3 per day

Alcohol: 1-2 per day

Does not exercise regularly

Occupation: IT analyst at database center.

Presentation:

Ms. Abe presents to your clinic today, last visit was more than a year ago. While at her employer sponsored health fair she had her BP checked and it was 156/100. She used her mother’s BP machine again last week twice and her BP was 148/98 and 144/92 at home. She takes her “fluid” pill every day which was given to her over year ago because her blood pressure was up and her feet were swelling. Last week she started taking two and decided she should make appointment to see her Nurse Practitioner when her BP did not come down.

You have decided that additional medication is required.  Evaluate the evidence-based options for controlling this patient’s blood pressure and provide rationale for your decision.  Identify and explain any patient-specific factors that influence your decision.

1. Discuss the pharmacokinetic and pharmacodynamics effects of her current and planned prescription drug therapy.
2. Describe the goals of treatment.
3. Discuss possible drug interactions.  Discuss medication-related issues that could contribute to the patient’s HTN. 
4. What evidence-based, non-pharmacologic approaches should be initiated?
5. What monitoring plan would you implement for this patient while on HTN meds and why?
6. Using the prescription template, please attach prescriptions for the medication regimen for the treatment of this patient’s hypertension
7. What is the cost for a one-month supply of medication for this patient?
8. What key patient education points will you like her to leave the office with (not an exhaustive list).
9. Write 3 multiple choice or true/false study questions that would help your classmates reinforce the main learning points of the case study? (include answers)