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Question 2
The Nurse Practitioner knows that Buproprion use (wellbutrin, zyban) is contraindicated in which of the following instances?
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Body dysmorphic disorder |
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Hyperlipidemia |
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In conjunction with a MAOI) monoamine oxidase inhibitor |
||
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peripheral neuropathy |
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- This patient is a 45 year old female admitted to the psychiatric unit for major depressive disorder withassociated psychosis. She has a history of breast cancer with inoperable metastases to the brain. NKDAAllergies NKDA Current MedicationsFentanyl (Duragesic) 75mcg/hr patch Q3daysSertraline (Zoloft) 200 mg po dailyLorazepam (Ativan) 0.5 – 2 mg po or IM q4h prn agitationRisperidone (Risperdal) 1 mg po BIDPhenytoin (Dilantin) 300 mg po QHSPMH Major depression with psychosisHx of breast cancerBrain metastases1. This patient is complaining that her gums are getting larger and are starting to grow over her teeth.What might be causing this?This patient is a 45 year old female admitted to the psychiatric unit for major depressive disorder withassociated psychosis. She has a history of breast cancer with inoperable metastases to the brain. NKDAAllergies NKDA Current MedicationsFentanyl (Duragesic) 75mcg/hr patch Q3daysSertraline (Zoloft) 200 mg po dailyLorazepam (Ativan) 0.5 – 2 mg po or IM q4h prn agitationRisperidone (Risperdal) 1 mg po BIDPhenytoin (Dilantin) 300 mg po QHSPMH Major depression with psychosisHx of breast cancerBrain metastasesWhat is the mechanism of action of sertraline and the common side effects?This patient is a 45 year old female admitted to the psychiatric unit for major depressive disorder withassociated psychosis. She has a history of breast cancer with inoperable metastases to the brain. NKDAAllergies NKDA Current MedicationsFentanyl (Duragesic) 75mcg/hr patch Q3daysSertraline (Zoloft) 200 mg po dailyLorazepam (Ativan) 0.5 – 2 mg po or IM q4h prn agitationRisperidone (Risperdal) 1 mg po BIDPhenytoin (Dilantin) 300 mg po QHSPMH Major depression with psychosisHx of breast cancerBrain metastases2. The physical therapist comes to you the next afternoon & states that he is unable to arouse thepatient for therapy. You enter the room and discover that the patient has been chewing on an oldfentanyl patch. She has probably overdosed. What medication can be given to this patient?
- This patient is a 45 year old female admitted to the psychiatric unit for major depressive disorder withassociated psychosis. She has a history of breast cancer with inoperable metastases to the brain. NKDAAllergies NKDA Current MedicationsFentanyl (Duragesic) 75mcg/hr patch Q3daysSertraline (Zoloft) 200 mg po dailyLorazepam (Ativan) 0.5 – 2 mg po or IM q4h prn agitationRisperidone (Risperdal) 1 mg po BIDPhenytoin (Dilantin) 300 mg po QHSPMH Major depression with psychosisHx of breast cancerBrain metastases1. This patient is complaining that her gums are getting larger and are starting to grow over her teeth.What might be causing this?2. The physical therapist comes to you the next afternoon & states that he is unable to arouse thepatient for therapy. You enter the room and discover that the patient has been chewing on an oldfentanyl patch. She has probably overdosed. What medication can be given to this patient?3. What are common side effects of fentanyl? How should they be…ENDOCRINE SYSTEM CASE: A 68-year-old male patient with type 2 Diabetes Mellitus has received optimal metformin monotherapy for the last 2 years (current dose of 2000 mg/day) and tolerates the treatment well. Hypoglycemia has not been an issue to date. His body mass index (BMI) is 28 kg/m2, which he has worked hard to reduce from 35 kg/m2 over the last 2 years. He has mild hypertension, which is well- controlled on a thiazide plus an angiotensin-converting enzyme inhibitor. His blood lipids are well-controlled on atorvastatin 10 mg daily. He now presents at the clinic with an HbA1c of 7.6%. After reviewing the available therapeutic choices and using a shared decision-making model, a dipeptidyl peptidase-4 (DPP-4) inhibitor is selected as add-on therapy based upon simplicity of use, tolerability, and the patient’s wish to avoid anything that might cause weight gain. What specific parts of the endocrine system is affected in this case? What are the normal functions of the body…This patient is a 45 year old female admitted to the psychiatric unit for major depressive disorder withassociated psychosis. She has a history of breast cancer with inoperable metastases to the brain. NKDAAllergies NKDA Current MedicationsFentanyl (Duragesic) 75mcg/hr patch Q3daysSertraline (Zoloft) 200 mg po dailyLorazepam (Ativan) 0.5 – 2 mg po or IM q4h prn agitationRisperidone (Risperdal) 1 mg po BIDPhenytoin (Dilantin) 300 mg po QHSPMH Major depression with psychosisHx of breast cancerBrain metastases The patient started to hallucinate and became combative with the staff. Her physician ordered 5mg ofhaloperidol to be given IM. Later that day the patient came to the nursing station complaining ofsevere spams in her neck and back. What is his happening to her and what is causing it?symptoms?
- ENDOCRINE SYSTEM CASE: A 68-year-old male patient with type 2 Diabetes Mellitus has received optimal metformin monotherapy for the last 2 years (current dose of 2000 mg/day) and tolerates the treatment well. Hypoglycemia has not been an issue to date. His body mass index (BMI) is 28 kg/m2, which he has worked hard to reduce from 35 kg/m2 over the last 2 years. He has mild hypertension, which is well- controlled on a thiazide plus an angiotensin-converting enzyme inhibitor. His blood lipids are well-controlled on atorvastatin 10 mg daily. He now presents at the clinic with an HbA1c of 7.6%. After reviewing the available therapeutic choices and using a shared decision-making model, a dipeptidyl peptidase-4 (DPP-4) inhibitor is selected as add-on therapy based upon simplicity of use, tolerability, and the patient’s wish to avoid anything that might cause weight gain. What are the risk factors/ causes of the medical condition? What are the ways to prevent these risk factors/…a 45 year old female admitted to the psychiatric unit for major depressive disorder withassociated psychosis. She has a history of breast cancer with inoperable metastases to the brain. NKDAAllergies NKDA Current MedicationsFentanyl (Duragesic) 75mcg/hr patch Q3daysSertraline (Zoloft) 200 mg po dailyLorazepam (Ativan) 0.5 – 2 mg po or IM q4h prn agitationRisperidone (Risperdal) 1 mg po BIDPhenytoin (Dilantin) 300 mg po QHSPMH Major depression with psychosisHx of breast cancerBrain metastases What are common side effects of fentanyl? How should they be monitored or avoided?a 45 year old female admitted to the psychiatric unit for major depressive disorder withassociated psychosis. She has a history of breast cancer with inoperable metastases to the brain. NKDAAllergies NKDA Current MedicationsFentanyl (Duragesic) 75mcg/hr patch Q3daysSertraline (Zoloft) 200 mg po dailyLorazepam (Ativan) 0.5 – 2 mg po or IM q4h prn agitationRisperidone (Risperdal) 1 mg po BIDPhenytoin (Dilantin) 300 mg po QHSPMH Major depression with psychosisHx of breast cancerBrain metastases 4. What are common side effects of risperidone?
- Treatments for Hypothyroidism Therapeutic Option Onset of Effect Adverse Effects Precautions or Contraindications Drug Interactions Dosing schedule, route of administration Liotrix Liothyronine Levothyroxine Thyroid-USPTreatments for Hypothyroidism Therapeutic Option Onset of Effect Adverse Effects Precautions or Contraindications Drug Interactions Dosing schedule, route of administration Liothyronine Levothyroxine Thyroid-USPURISTAT MEDICATION IN EACH CATEGORY OF DRUGS AND APPLY THE 10 R’S TO MEDICATION Fill out all the the blanks in the table below.CATEGORY 4 : DRUGS USED FOR WOMEN’S HEALTH(URISTAT) 10 R’s TO MEDICATION BRIEF DISCUSSION OF EACH OF THE 10R’s TO MEDICATION APPLICATION (URISTAT) 1. RIGHT DRUG(URISTAT) 2. RIGHT DOSE 3. RIGHT TIME 4. RIGHT ROUTE 5. RIGHT PATIENT 6. RIGHT TO EDUCATE 7. RIGHT TO REFUSE 8. RIGHT ASSESSMENT 9. RIGHT EVALUATION 10. RIGHT DOCUMENTATION