Pharmacotherapeutics

¶ … Pharmacotherapeutics Read case study answer case study questions follow. Please list reference answering case study questions Attached Case study Rubric assignment. Specific goals of therapy for Heather The specific therapy goals for Heather are preventing any long-term symptoms that will interfere with her daily living, such as the shortness of breath with exercise.

According to Bateman, Frith, and Braunstein (2002) maintenance of lung function to a near personal best measurement, therapy should allow her to participate in all her activities of daily living, which include school, exercising, and participating in sporting activities. The treatment therapy should reduce the nighttime symptoms in order for her to achieve uninterrupted sleep. Few and if possible no side effects from the medicines, and the prevention of repeated attacks. Heather should use the quick relief medications less often with continued treatment therapy.

Drug therapy prescribed by the nurse practitioner Drug therapy is the main way for the treatment and management of Asthma. The drugs are used to relieve symptoms, control the disease, attempt to prevent the symptoms, and treat exacerbations Sears et al., 1990. The nurse practitioner would prescribe short-acting beta-agonists like salbutamol and terbutaline. The nurse might also prescribe inhaled corticosteroids (budesonide, beclomethasone, ciclesonide, and fluticasone). Anti-inflammatories might be prescribed to assist in reducing production of mucus in the airways, and the swelling.

These medications will assist Heather to exercise without shortage of breath, and sleep well at night. The nurse might also prescribe bronchodilators, which will open up the airways and improve her breathing. Monitoring the success of therapy In order to assess properly the success of therapy one needs to analyze lung function. Lung function should be periodically tested to check the severity of the symptoms Nathan et al., 2004. The patient's quality of life is another parameter for monitoring therapy success.

Analyzing how often the patient fails to perform their daily activities in this case attending school and soccer practice, the nurse is able to determine if the therapy is effective. Monitoring the history of asthma attacks is vital. Substances causing the inflammation of the airways trigger asthma attacks and understanding when the attacks occur, and knowing what the triggers are will assist in determining the best therapy. Patient teaching The nurse practitioner should educate Heather on how the airways work.

This will allow Heather to understand why she gets the shortage of breath with exercise and the difficulty in breathing while sleeping. The nurse should teach and reinforce peak flow monitoring techniques. This monitoring is helpful to Heather as she is unable to perceive the symptoms. Peak flow monitoring enables Heather to assess her level of asthma, and recognize any signs of its worsening. Heather should understand that there is no cure for asthma, but with treatment, asthma is manageable. The symptoms can go away after minimal treatment.

Adverse reaction to the agents selected Using salbutamol can lead to headaches, anxiety, muscle cramps, tremor, and dry mouth. There is a likelihood that the patient might have some disturbances of sleep. These adverse effects would necessitate the change to another form of therapy. Beclomethasone can cause some adverse effects like coughing after inhalation, unpleasant taste, or nasal congestion Boulet, 1998. These are minor adverse effects, but if the patient is not comfortable, it is advisable to administer another form of therapy.

Second-line therapy The best for second-line asthma therapy would be long-acting beta-agonists and leukotriene antagonists Lipworth & Jackson, 2002. These therapies are both effective.