This case study will help you practice analyzing a patient record, which will assist you in preparing for the final project.
This case will focus specifically on musculoskeletal and integumentary drug treatment.
Prompt: Consider the following scenario: Ms. Craft, age 59, was brought by ambulance to the emergency room because she thought she was dying. She had difficulty breathing, was dizzy if she attempted to sit up, and felt a sense of impending doom. Ms. Craft assumed that she was having a heart attack, and so did the admitting emergency room personnel.
But the case was more complicated. Physical examination showed Ms. Craft to have weakness, malaise, warm skin, and hypotension. Ms. Craft said she felt nauseous. A blood glucose value was really high. Cardiac markers did not show that she was having a heart attack, nor did an EKG. When her history was taken, Ms. Craft said she had not seen a doctor in several years and was unaware that she had diabetes.
Her respirations were deep and rapid—Kussmaul respirations.
In this case, the ER physician diagnosed decompensated diabetes mellitus with metabolic acidosis. These were the medications prescribed:
· Oxygen by mask
· Hypertonic IV fluids
· Insulin orally
· Hydrochloric acid solution via IV
In a short paper, the following critical elements must be addressed:
· Identify the incorrect medication/drug classification/treatment and explain why it is incorrect.
· What drug classification would you use instead? Why?
· Provide an example of a generic medication from each drug classification. How would each of the medications/treatments in the scenario act on the patient’s body?
Support your answer with relevant resources.
Expert Solution Preview
Introduction: In this case study, Ms. Craft was diagnosed with decompensated diabetes mellitus with metabolic acidosis. The medications prescribed had some incorrect medication/drug classifications/treatment. This paper will address the incorrect medication and drug classification used in this scenario, suggest what drug classification should have been used, and provide examples of generic medications from each drug classification.
1. Identify the incorrect medication/drug classification/treatment and explain why it is incorrect.
The incorrect medication/drug classification/treatment prescribed in this scenario is insulin orally. Insulin is not absorbed through the gut and must be given through injection or infusion. Therefore, insulin should have been prescribed through injection or infusion, not orally.
2. What drug classification would you use instead? Why?
The drug classification that should have been used instead of insulin orally is insulin injection or infusion. These methods are the standard way of administering insulin.
3. Provide an example of a generic medication from each drug classification. How would each of the medications/treatments in the scenario act on the patient’s body?
Examples of generic medications for insulin injection include Humulin and Novolin. Insulin infusion medications include Novolog and Humalog. Insulin helps lower blood glucose levels by stimulating glucose uptake into tissues and inhibiting glucose production by the liver.
Examples of generic medications for hypertonic IV fluids include 3% saline and 5% dextrose. Hypertonic IV fluids help restore vascular volume and improve perfusion pressure.
Examples of generic medications for Hydrochloric acid solution via IV include Acid concentrate and Hydrochloric acid. Hydrochloric acid is used to correct metabolic alkalosis and metabolic acidosis.
Sources:
1. MedlinePlus. (n.d.). Insulin Injection. Retrieved from https://medlineplus.gov/druginfo/meds/a682611.html
2. MedlinePlus. (n.d.). Insulin Infusion. Retrieved from https://medlineplus.gov/druginfo/meds/a682607.html
3. Goodman, L. S., & Brunton, L. L. (2011). Goodman and Gilman’s The Pharmacological Basis of Therapeutics, Twelfth Edition. New York: McGraw-Hill Medical.
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