Good Case Study About Pharmacology Case Study

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QUESTION 1:

Considering Lillian a geriatric patient, pain assessment can be done by using various pain assessment tools. According to Herr and Garand (2001), in elderly patients self-report intensity tools and numeric rating scales are widely used. Commonly used self-report intensity tools are verbal descriptor scale (VDS), faces pain scales (FPS) and visual analogue scale (VAS).
Acetaminophen is non-opioid analgesic and since its concentration peaks within 30 to 60 minutes in blood, nurse should reassess Lillian’s status after that time to improvise and record the treatment plan and its outcome.

QUESTION 2:

Zolpidem is a newer hypnotic and reaches peak plasma concentration in 1.6 hours. It acts by binding with the selective GABAA-receptors containing α1 subunits. This potentiates the inhibitory neurotransmitter; Gamma Amino Butyric Acid (GABA) and functions within 15 minutes of administration. It should be administered with care in elderly due to risk of falls, high risk occupation like driving. It is pregnancy category C and can cause GERD.

QUESTION 3:

Heparin is a thrombolytic which acts by accelerating the action of antithrombin in the blood to 1000 folds. The half-life of heparin is one hour which necessitates repeated and frequent administration. Its onset of action is delayed to 1 to 2 hours if given through subcutaneous route. It can cause bleeding, thrombocytopenia, and derangement of hepatic enzymes.

QUESTION 4:

Warfarin is a coumarin anticoagulant. It acts by antagonizing the vitamin K and its functions promoting anticoagulation. It becomes detectable in plasma within 1 hour of administration and its concentration rises within 2 to 8 hours. It can also cause bleeding, birth defects if taken during pregnancy, skin necrosis, and purple toe syndrome.

References

Herr, K. A., & Garand, L. (2001). Assessment and measurement of pain in older adults. Clinics in Geriatric Medicine, 17(3), 457–vi.