No plagiarism will be accepted  

Instructions: Body of textHistory-history of creation/discovery and use-describe the chemical make-up of the drug (i.e., Crack is cocaine hydrochloride powder that has been processed to form a rock crystal that is then usually smoked).

At least half a page.

Production-is the drug natural or synthesized in the lab? 

Ex: designer drug LSD (lab) versus naturally growing mushrooms (natural).  At least half a page. 

Influence on Neurotransmitters and Receptors-Describe what neurotransmitters/receptors/hormones are involved. 

How does the drug influence them? (be specific, i.e., serotonin receptors or even more specific, 5HT). At least half a page.

Effectiveness, Use and/or Abuse-what is the effectiveness of the drug (if it is used clinically) or if illicit, how potent is it (maybe talk here about cutting street drugs with other chemicals like baking soda, etc). 

-is the drug abused? 

If yes describe in terms of prevalence of use and abuse. 

If no describe why-is the drug addictive or does it build a physical tolerance (need to increase the dose to keep working)?

 If yes then how do you stop using it (taper down the dose, etc.). If no, then say why the receptors that it works on do not up or down regulate, etc.).  At least a page. 

Physical, Mental, and Social Benefits/Dangers -Is this drug dangerous or useful or beneficial (physical, to the self,  the repercussions to society, to research, and the field of psychology) describe how and why? 

At least a page.Conclusion -write a brief summary of the main points. -based on the research, is there conflicting data about the drug?

 Is this supported by research? 

Mention any discrepancies in the research that should be addressed.

Make sure you choose one specific drug and its influence on one specific population as we talked about in class.

A research paper is required to pass the course.  A 6 page APA paper based on a related biological psychology topic/phenomenon. On this paper, you will explore the influence and effects of a specific drug e.g. caffeine, alcohol, cocaine, Ritalin, etc.  on a specific target population of interest e.g. young college students, children with ADHD, women with bipolar disorder, young women with anorexia,

Number of Pages: 6 Pages

Page Line Spacing: Double spaced (Default)

Academic Level: College

Paper Format: APA

Peer reply pharmacy DB5

1 -triana

DERMATOLOGY CASE STUDY

 Chief complaint: “ My right great toe has been hurting for about 2 months and now it’s itchy, swollen and yellow. I can’t wear closed shoes and I was fine until I started going to the gym”.

HPI: E.D a 38 -year-old Caucasian female presents to the clinic with complaint of pain, itching, inflammation, and “yellow” right great toe. She noticed that the toe was moderately itching after she took a shower at the gym. She did not pay much attention. About two weeks after the itching became intense and she applied Benadryl cream with only some relief.  She continued going to the gym and noticed that the itching got worse and her toe nail started to change color. She also indicated that the toe got swollen, painful and turned completely yellow 2 weeks ago. She applied lotrimin  AF cream and it did not help relief her symptoms. She has not tried other remedies.

Denies associated symptoms of fever and chills. 

 1.According to the AAFP/CDC Guidelines, what antifungal medication(s) should this patient be prescribed, and for how long? Write her complete prescriptions using the prescription writing format in your textbook.

 Onychomycosis is a fungal infection of the nail, either fingernail or toenail. The common dermatophyte that is found in onychomycosis is tinea unguium , with candida infections also a cause . Effective treatment usually involves months of systemic antifungal medication, commonly griseofulvin, ketoconazole ,itraconazole or terbinafine. Topical treatment is usually not effective except for ciclopirox nail lacquer (Woo & Robinson, 2016).

 

Terbinafine 250mg 1 tab PO daily x 12 weeks 

 Terbinafine 250mg take one tablet by mouth daily for 12 weeks 

 2.  What labs for baseline and follow up of therapy would you order for this patient?

Liver enzymes and complete blood count should be monitor every 6 weeks if treatment last longer than 6 weeks. 

 Terbinafine is an orally and topically active allylamine fungicidal agent which is used to treat superficial fungal infections of the skin and nails.  Terbinafine has been clearly linked to rare instances of acute liver injury that can be severe and sometimes fatal.

Drug induced liver injury due to terbinafine was identified shortly after its introduction into medical use.  Oral therapy with terbinafine is associated with elevations in serum aminotransferases in less than 1% of patients and the elevations are generally asymptomatic and resolve without stopping therapy.  The estimated probability of developing elevated serum aminotransferase levels requiring stopping treatment is about 0.31% for 2 to 6 weeks’ treatment and 0.44% for treatment longer than 8 weeks (“Terbinafine”, 2019).

 

Reference 

Woo, T. M., & Robinson, M. V. (2016). Pharmacotherapeutics for advance practice nurse prescribers. Philadelphia: F.A. Davis Company.

 Terbinafine. (2019, July 1). Retrieved September 30, 2019, from https://livertox.nlm.nih.gov/terbinafine.htm.

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2- Rivera

 

 

 

Part 2: Labs 

            Because Terbinafine is metabolized by the liver, will be important to perform hepatic function testing for the patient due to the risk of liver enzyme elevation, and establish a baseline. Liver enzymes and complete blood count should be done every 6 weeks, during treatment (Woo and Robinson, 2016).  

 

References

Woo, T. & Robinson, M., V. (2015). Pharmacotherapeutics for advanced practice nurse prescribers. Philadelphia, PA: F. A. Davis company.

 

Follow up 

Specify when to refer the patient after therapy and why? Provide rationale.

According to the recommended guidelines, what are the non-pharmacological approaches to Onychomycosis? Provide patient education. Keep in mind the past medical history of this patient.

Patient should be referring to Podiatrist for follow up. Foot care is essential for the diabetic patient, and should definitely follow up with podiatrist for further treatment.  

Patient will also be referred to endocrinologist for follow up due to her history of diabetes mellitus type 2. There is no documentation that diabetes is being treated. Patient is obese which may indicate she is not following an appropriate diet.  A referral will also be given to a dietician due to obesity (BMI: 31). 

According to Woo and Robinson Vicks VapoRub is commonly used for onychomycosis. A pilot study was conducted by Derby, Rohal, Jackson, Beutler, and Olsen (2011), to test Vicks VapoRub as a non-pharmacological approach to treat onychomycosis. The study included 18 participants and 83% had a positive response to this treatment after a course of 48 weeks. This study was done with a small sample; however Vicks VapoRub still showed to be a safe and cost-effective non-pharmacological treatment of onychomycosis (Derby, Rohal, Jackson, Beutler, and Olsen, 2011). 

Patient was educated on importance of an adequate diet that includes appropriate daily servings of fruits and vegetables, food low in saturated fat and low cholesterol. Patient was encouraged to continue being active, getting at least 30 minutes of regular physical activity.  Also encouraged to start taking Omega 3 fatty acids to help increase her HDL which is low (38mg/dl) and this is considered a risk factor for heart disease. 

References

Derby, R., Rohal, P., Jackson, C., Beutler, A. & Olsen, C. (2011). Novel treatment of 

onychomycosis using over the counter mentholated ointment: A clinical case series. 

Journal of the american board of family medicine (24)1 69-74. 

doi: 10.3122/jabfm.2011.01.100124

Woo, T. & Robinson, M., V. (2015). Pharmacotherapeutics for advanced practice nurse prescribers. Philadelphia, PA: F. A. Davis company.

 

Minimum of 300 words with two or more peer review reference

 

Identify the process of rational drug prescribing. Pick a condition and determine what steps you would complete specific to this condition to properly prescribe, manage, regulate, and educate the pharmaceutical need for your patient. What process would you institute in your future practice to ensure rational prescribing with new evidence-based practice guidelines?

 

Review the Institute of Medicine (IOM) report: “The Future of Nursing: Leading Change, Advancing Health,” focusing on the following sections: Transforming Practice, Transforming Education, and Transforming Leadership.

Write a paper of 750-1,000 words about the impact on nursing of the 2010 IOM report on the Future of Nursing. In your paper, include:

1. The impact of the IOM report on nursing education.
2. The impact of the IOM report on nursing practice, particularly in primary care, and how you would change your practice to meet the goals of the IOM report.
3. The impact of the IOM report on the nurse’s role as a leader.

Cite a minimum of three references.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

 

Select a nursing research article from the list below that includes a theoretical or conceptual framework and the exploration of a clinical problem. Identify the nursing research article components using the Week 5 research template.

(All articles are available in the South University Online Library.)

Emotional Work and Diversity in Clinical Placements of Nursing Students

Nurses’ Preparedness and Perceived Competence in Managing Disasters

The Lived Experiences of People with Chronic Obstructive Pulmonary Disease: A Phenomenological Study

Effects of Multivitamin Supplements on Cognitive Function, Serum Homocysteine Level, and Depression of Korean Older Adults with Mild Cognitive Impairment in Care Facilities

The template will be evaluated on the effectiveness of the discussion of the following components. If a component is not present in the article, its absence should be discussed.

• Identify the research problem.
• Identify the research purpose.
• Summarize the review of literature.
• Identify the nursing framework or theoretical perspective.
• Identify the research questions and hypotheses.
• Identify the variables.
• Identify and discuss the appropriateness of the design.
• Discusses the validity and reliability of the instruments, tools, or surveys.
• Discuss the significance of the study. Did it resolve the question?
• Discuss the legal and ethical issues of the study. Include the use of human subjects and their protection.
• Describe any cultural aspects of the study.
• Describe the final sample.
• Describe the procedures for data collection.
• Summarize the results including statistical analysis used or other method of analysis.
• Describe how the results of the research may impact future nursing practice.
• Apply the research to the student’s nursing practice.
• NOTE: If a component is absent, student receives a zero for that component.

Submission Details:

• Cite any resources in APA style and include a copy of the article with the submission.
• By the due date assigned, submit your template to the Submissions Area.