Scenario
Mr. Henry Navarro, a 62 y.o. Hispanic male patient, is coming in to establish care with you today. He states that he has been feeling well, but he has noticed some tingling in his feet and rashes in his private area. In obtaining his history, he revealed that he had a cardiac stent placed about 6 months ago and was given some medications from his previous primary care provider and cardiologist. He has run out of medications and does not remember what they were. He remembers he was taking something for high sugar, high blood pressure, cholesterol, and blood thinner. He also has been feeling depressed since he is not able to do the things he used to do. He does not have energy and lost interest in things he used to do. He also noticed some productive coughing and shortness of breath after exertion. He states that he has been smoking since he was 16 y.o. and continues to smoke one pack a day.
After thorough physical assessment and reviewing some documents you could gather, you decide that he has the following conditions:
• DM Type II – His last A1c is 7.2 and has been on Metformin 500mg two tabs bid
• Hyperlipidemia – not on any med now and last LDL was 102
• HTN – not on any med and his BP is running in 150’s /100’s
• Depression – Not on any meds; he is feeling very depressed and wants meds to help him feel better; denies of any SI/HI
• CAD – he was told to take a low dose ASA once a day but not taking it. He is wondering if he should
• S/P Cardiac Stent placement x 1 – last seen by his cardiologist over 6 months ago. He was on a blood thinner but does not remember a name.
• COPD – never been diagnosed until hospitalized. He has a albuterol inhaler but still feeling SOB. He is asking if you can give him something to help with his cough and SOB.
• Peripheral Neuropathy due to DM – He would like some medication to help with tingling sensation and pain.
After reviewing the case scenario above, answer the following questions in 500 to 700words.
Use UpToDate located in the University Library to search for and locate the most current evidence-based guidelines to answer the following questions.
1. Pharmacokinetics and Pharmacodynamics: Discuss the concepts of pharmacokinetics and pharmacodynamics and how they may impact appropriate medication selection.
2. Dosing and Side Effects: Indicate how the pharmacokinetics will determine the dosing frequency and consider the side effects.
3. EBP Guidelines and Pharmacokinetic Impact: Select 2 patient assessments (diagnoses) and medications to treat those conditions based on evidence-based guidelines to discuss pharmacokinetics impact on their conditions, dosing frequency, and side effects.
