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• When recommending medications, write out a complete prescriiption 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.
• Use clinical practice guidelines in developing your answers. Please review all Required Learning Resources. Use the Medscape app or website and JNC 8 to complete assignment.
• Include at least three references to support each scenario and cite them in APA format. Please include in-text citations. You do not need an introduction or conclusion paragraph.
SCENARIO 1
Why are cytochrome P450 enzymes (CYPs) important in drug metabolism? The majority of medications are metabolized by what CYP enzyme? Utilizing the Medscape pill identifier, enter the following characteristics to identify the medication. What CYP enzyme metabolizes this medication? Write a sample prescriiption for it.
Imprint (ATO 40) Shape (Oval) Color (White) Form (Tablet) Scoring (None)
SCENARIO 2
JS is a 56-year-old female presenting with redness, warmth and tingling sensation in her neck and face. Current medications include semaglutide (Ozempic) 0.5 mg SC qWeek and Niacin 1,000 mg BID. She is 5’4” and weighs 175 lbs. Fasting lipid profile shows total cholesterol 200, LDL cholesterol 110, and Triglycerides 150. Blood pressure readings of 139/91 and 140/89. What is the patient’s HDL? BMI? What are goal Total Cholesterol, HDL, LDL, and Triglyceride levels for JS? What treatment plan would you implement (include complete medication orders)? How would you monitor the effectiveness of your treatment plan? How many risk factors for coronary artery disease does she have? Identify them specifically.
SCENARIO 3
CL is a 48-year-old African American male with blood pressure readings today of 159/91 and 165/95. He states he is taking Advil Cold & Sinus for a cold x 1 week. Additional medications include adalimumab 40 mg subcutaneous injection every other week, Wellbutrin XL 300 mg daily and pantoprazole 40 mg daily 30 minutes before breakfast. How would you treat CL? What would you prescribe (include complete medication order)? What is his goal blood pressure per JNC 8?
SCENARIO 4
Does nitroglycerin have a high or low first pass effect? Please discuss why this is important to know and how it relates to bioavailability. What route has 100% bioavailability? In addition to parenterally, how can this medication be given to counter the first pass effect? Write a sample prescriiption for this medication.
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