WEEK 4 DISCUSSION PAHRAMCOLOGY

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This discussion is based on the textbook reading from Hitner & Nagle and ALL unit material. Before contributing to the discussion, review the required reading and lecture material. Unit 4 Student Learning Outcomes Categorize the major pharmacological classes and indications of weekly prototype. Summarize mechanisms of action of the pharmacological classes and major prototype drugs. Identify the side effects, adverse reactions, and contraindications of each major prototype. Provide therapeutic considerations of each major prototype. Unit 4 Prototype Drugs GABA Diazepam (Valium): benzodiazepine Phenobarbital (Luminal): barbiturate Serotonin fluoxetine (Prozac): SSRI Sumatriptan (Imitrex) Serotonin agonist Ondansetron (Zofran) Serotonin antagonist Dopamine Levodopa Agonist: ropinirole bupropion (Wellbutrin): DNRI Antagonist: haloperidol Misc imipramine (Tofranil): TCA lithium (Eskalith): mood stabilizer methylphenidate (Ritalin): CNS stimulant MOAI* Choose one of the following topics to discuss in paragraph form with no fewer than 6 sentences. Scenario #1: SS, a 26-year-old woman, takes phenytoin 100 mg t.i.d. to control grand mal seizures. SS and her husband are contemplating starting a family. SS complains of frequent “upset stomach” and “bleeding gums” when brushing her teeth and is questioning if other anticonvulsants are more appropriate than phenytoin. List a few different classifications of anticonvulsant medications and briefly explain how they work. Describe a situation in which each could be prescribed. (USLO 4.1,4.2) Explain the general teaching points of anticonvulsants. (USLO 4.2, 4.3, 4.4) If S.S was contemplating pregnancy what would you say to her? How do anticonvulsants impact pregnancy? (USLO 4.3, 4.4) What are the indications of an abnormal phenytoin serum level? (USLO 4.3, 4.4) Scenario #2: An 82-year old woman who resides in a nursing facility is admitted to the hospital with pneumonia. She has a history of agitation and is ordered the antipsychotic haloperidol. How do antipsychotics work? What neurotransmitter is greatly affected by antipsychotics? (USLO 4.1, 4.2) When you assist the patient up you notice muscle rigidity and shuffling gait. What is the patient experiencing? Explain the characteristics of this syndrome. How is it treated? (USLO 4.3) What are the major side effects and adverse effects seen with haloperidol? (USLO 4.3, 4.4) What is included in education for a patient taking antipsychotics? (USLO 4.3,4.4) Scenario #3 You are assigned to care for a patient prescribed fluoxetine. The patient’s son arrives and tells you that his mother already has a prescription for fluoxetine, but stopped taking the medication after 1 week because she did not feel any better. What drug classification is fluoxetine? How does this classification work? (USLO 4.1, 4.2) What side effects/adverse reactions will you monitor for? (USLO 4.3) What teaching needs to be included when giving this medication? (USLO 4.3, 4.4) How will you address the son’s concern over his mother’s compliance with the antidepressant? (USLO 4.4) Requirements: Post your initial response to the prompt(s) by Day 4 midnight, including any necessary citations to appropriate readings. Make sure to provide some examples from the text and lecture material (located in the Unit folders), as well as from your own experiences. In your responses, I want to see your informed input. In other words, don’t simply recite the text and don’t simply give me your opinion. Your input should be in your own words, demonstrating your understanding and comprehension of the topic. Be sure to support your postings and responses with specific references to the assigned readings and lecture material, as well as any other relevant research you find appropriate. This is a first post forum meaning you will not be able to see the posts of others until you create your initial post. Read a sampling of your colleagues’ postings. Then, I want to see each of you responding to some of your classmates’ posts for an additional 2 days during the week. Please note this is NOT the same thing as two additional posts. It is posting on TWO additional (different) days during the week. Therefore, to meet just the minimum frequency of posting in the forum, each student must be present and post on at least 3 separate days during the week. Respond to at least two of your colleagues’ posting by Day 7 midnight in one or more of the following suggested ways: • Ask a probing or clarifying question. • Share an insight from having read the colleagues’ posting. • Offer and support an opinion. • Validate an idea with your own experience. • Make a suggestion and support it. • Expaagnnd on the colleague’s posting