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NUR 641E Topic 1: General Physiological And Pathophysiological Concepts

NUR 641E Topic 1: General Physiological And Pathophysiological Concepts

NUR 641E Topic 1: General Physiological And Pathophysiological Concepts

Objectives:

  1. Describe principles of immunology in disease processes.
  2. Evaluate the inflammatory response as a defense mechanism.
  3. Evaluate the principles of cellular alterations in infection and the medications that treat infection.
  4. Describe a pharmacological intervention using an evidence-based treatment guideline.

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NUR 641E Topic 1: General Physiological And Pathophysiological Concepts Topic 1 DQ 1

Start Date

Mar 3, 2022, 12:00 AM

Due Date

Mar 5, 2022, 11:59 PM

Points

5

Status

Published

Assessment Description

Part 1

What are the differences between primary and secondary line of defense? What factors interfere with these mechanisms? How are these levels of immunity affected in a child, an elderly person, or a person with a chronic disease? Include active, passive, innate, and acquired immunity.

Part 2

Choose an inflammatory or infectious process and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Make sure that you select a different medical condition than your peers. Include the name of the medical condition in the subject line so that the medical condition can be followed. Include your references in APA style.

Cristina Alimon

Posted Date

Mar 12, 2022, 8:21 PM

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Replies to Vanessa Brown

Proton Pump Inhibitor (Omeprazole)

Proton-pump inhibitors (PPIs) are a family of medications best recognized for their use in treating acid-related illnesses. When used as part of an all-natural treatment plan with other medicines, this effect can help heal a peptic ulcer, treat gastroesophageal reflux disease, treat Barrett’s esophagus, and even get rid of Helicobacter pylori (Ahmed & Clarke, 2021). With my experience in home health nursing before, most older patients take Omeprazole, especially if they have multiple drug maintenance. Some of the patients were prescribed maybe eight or more medications, and one of those is Omeprazole. Most of the time, they are discharged from hospital admission new medication will be added. It was always a struggle to coordinate with multiple physicians that the patient is seeing to verify the necessary medication they need to take as long term, and that is only short term. There was a patient that during the initial intake visit I asked him about why he is taking Omeprazole, he said because of GERD from all the medications that he is taking. Therefore, it is essential to be careful about our older patients’ medications. Because the more medications they are taking, the more susceptible they are to the adverse reactions from medications. Therefore, it is essential to educate the patient, give them an updated medication list, and instruct them or the family that they bring all the medication they are taking each time they see a physician to avoid duplication or unnecessary medication prescription.  

Pharmacokinetics of Proton Pump Inhibitor 

Absorption

The proximal small bowel absorbs these drugs, and when they reach the stomach’s parietal cells, they influence the cells (Ahmed & Clarke, 2021). The proton pump is an enzyme in the parietal cells that PPIs stop. This enzyme is the last step in releasing acid into the stomach, and it does this job very well.

Metabolism

Omeprazole is broken down by the hepatic cytochrome P450 enzyme system, mainly through CYP2C19 and CYP3A4 isozymes. It has a short half-life of a half-hour to an hour in healthy people and about three hours for people who have a problem with their liver (Shah, 2020).

Distribution

Within an hour of taking Omeprazole, the drug’s effects start to slow down. It takes two hours for the drug’s full effects to kick in. The effects of the drug last for about 72 hours after it is taken, and they usually wear off in 3 to 5 days. It will take four days for the effects to level off when taking medicine every day (Shah, 2020).

Excretion

Urinary excretion is the principal mechanism of omeprazole metabolite elimination (Shah, 2020).

Reference

Ahmed, A., & Clarke, J. O. (2021, August 1). Proton pump inhibitors (PPI) – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK557385/

Shah, G. W. (2020, October 17). Omeprazole – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK539786/

Topic 1 DQ 2

GO TO DISCUSSION

Start Date

Mar 3, 2022, 12:00 AM

Due Date

Mar 7, 2022, 11:59 PM

Points

5

Status

Published

Assessment Description

Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

Topic 1 DQ 2

Mar 3-7, 2022

Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

REPLY TO DISCUSSION

CA

Cristina Alimon

Posted Date

Mar 7, 2022, 11:39 PM

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Replies to Cristina Alimon

Cyclophosphamide

Cyclophosphamide, with the brand name of Cytoxan, is one of the medications given for Goodpasture disease to suppress the immune system in making anti-glomerular basement membrane (GBM) antibodies. Primarily this medication is for cancer like ovaries, breasts, blood, and others.

Mechanism of action

Cyclophosphamide is a cancer drug under a class of alkylating agents. The CYP450 system converts cyclophosphamide and ifosfamide to hydroxylated intermediates in the liver. The active chemicals phosphoramide mustard, and acrolein, are formed from the hydroxylated intermediates. The phosphoramide mustard reacts with DNA, causing cytotoxicity (LaPlant, & May 2019). Cyclophosphamide slows the development of cancer cells, which the body eventually destroys. Other side effects may develop because cyclophosphamide affects normal cell growth.

Hints for monitoring

Cyclophosphamide can temporarily reduce white blood cell counts, increasing the risk of infection and reducing the platelet count required for blood clotting (Mayo Clinic, 2022). Particular care must be taken to avoid infection or bleeding. Therefore, it is essential to instruct the patient to follow bleeding precautions. Avoiding contact sports and other circumstances that might cause bruising, cuts, and brushing or flossing teeth; monitor for signs of bleeding like bruises, blood in the urine or stools, or tiny red patches on the skin. Cyclophosphamide may reduce the body’s resistance, causing the vaccination to fail or the illness to occur; the patient should also avoid others who have received live virus vaccinations since they may spread the infection to the patient (Mayo Clinic, 2022).

Side effects

More common side effects are cough or hoarseness, fever or chills; lower back or side pain; missing menstrual periods; and painful or difficult urination (Mayo Clinic, 2022). The following side effects with high doses and long-term treatment are blood in the urine; dizziness, confusion, or agitation; fast heartbeat; joint pain; shortness of breath; swelling of the feet or lower legs; and unusual tiredness or weakness. Studies on nursing mothers show detrimental impacts on babies. It should be provided an alternative or discontinue nursing while using it.

Drug interaction

Cyclophosphamide has notable drug interactions with phenobarbital, phenytoin, digoxin, and anticoagulants (LaPlant, & May 2019). Chronic high dosages of phenobarbital enhance the metabolism and leukopenic action of cyclophosphamide. Therefore, warfarin’s impact is enhanced or decreased in individuals receiving warfarin plus cyclophosphamide (U.S. National Library of Medicine, 2021). NUR 641E Topic 1: General Physiological And Pathophysiological Concepts

References:

LaPlant, K., & May, P. (2019). Anticancer Drugs. In K. Whalen (Ed.), Lippincott® illustrated reviews: Pharmacology (7th ed.). Wolters Kluwer.

Mayo Clinic. (2022, February 14). Cyclophosphamide (Oral route, intravenous route) description and brand names – Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/cyclophosphamide-oral-route-intravenous-route/description/drg-20063307

U.S. National Library of Medicine. (2021, September 28). Cyclophosphamide injection, solution. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a0e99679-f939-4fb3-9d38-dfdb824f89bc

Topic 2: Principles For Safe Use Of Pharmacologic And Herbal Substances

Mar 10-16, 2022

Max Points:197

Objectives:

  1. Analyze the impact of pharmacologic agents on a patient’s health status considering physiology, pathophysiology, pharmacokinetics, pharmacodynamics, and patient knowledge.
  2. Evaluate drug actions to promote safe and effective drug therapy.
  3. Identify ethnic, cultural, and genetic differences in patients that may affect the safety or efficacy of medications.
  4. Integrate knowledge of pathophysiology and pharmacology into teaching and educational materials in diverse settings.

Assessments

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Topic 2 DQ 1

GO TO DISCUSSION

Start Date

Mar 10, 2022, 12:00 AM

Due Date

Mar 12, 2022, 11:59 PM

Points

5

Status

Published

Assessment Description

The Beer’s criteria contain a list of drugs that are potentially unsafe for use in older persons. Utilize the provided resource, “American Geriatrics Society 2019 Updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults” for assistance in completing this question. Select a drug on the “avoid” list that you have administered to an older patient or a drug that you know is prescribed for an older adult. Relate the outcome of using this drug to the pharmacokinetics (absorption, metabolism, distribution, and excretion) of drugs in an older client. In addition to the link, cite one other reference to support your post. Make sure that you select a different drug than your peers. Include the name of the drug in the subject line so that the drugs can be followed. Include your references in APA style.

Topic 2 DQ 2

GO TO DISCUSSION

Start Date

Mar 10, 2022, 12:00 AM

Due Date

Mar 14, 2022, 11:59 PM

Points

5

Status

Published

Assessment Description

Many people are using herbal medications and dietary supplements for the prevention and treatment of medical problems. Review two current research articles about two of these products. Based on the findings, what would be the implications for you as a nurse? What additional research needs to be done in this area? Cite the two references to support your answer. Make sure that you select different herbal medications and dietary supplements than your peers. Include the name of the herbal medication and dietary supplement in the subject line so that the medications can be followed. Include your references in APA style.

Content Lesson Presentation

REVIEW ASSIGNMENT

Start Date

Mar 10, 2022, 12:00 AM

Due Date

Mar 16, 2022, 11:59 PM

Points

167

Rubric

View Rubric

Status

Published

Assessment Description

Create an 8-9 slide presentation with speaker notes about a selected disease process and drug class. The presentation should provide content specific information on the selected disease process and drug class for staff or learners in a clinical environment.

Follow these steps:

  1. Select a disease process and a drug class used to treat the disease process.
  2. Describe pharmacokinetics and pharmacodynamics of the drug related to the pathophysiology of the disease process.
  3. Describe the product, its intended use, side effects, adverse reactions, and safety issues.
  4. Identify ethnic, cultural, and genetic differences in patients that may affect the safety or efficacy of medications.
  5. How would you monitor the desired effect is achieved?

Be sure to include three to five references.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

Topic 2 DQ 1

Mar 10-12, 2022

The Beer’s criteria contain a list of drugs that are potentially unsafe for use in older persons. Utilize the provided resource, “American Geriatrics Society 2019 Updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults” for assistance in completing this question. Select a drug on the “avoid” list that you have administered to an older patient or a drug that you know is prescribed for an older adult. Relate the outcome of using this drug to the pharmacokinetics (absorption, metabolism, distribution, and excretion) of drugs in an older client. In addition to the link, cite one other reference to support your post. Make sure that you select a different drug than your peers. Include the name of the drug in the subject line so that the drugs can be followed. Include your references in APA style.

REPLY TO DISCUSSION

VB

Vanessa Brown

Posted Date

Mar 13, 2022, 12:52 AM

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Replies to Vanessa Brown

Zolpidem (Ambien)

Zolpidem is a non-benzodiazepine receptor modulator that is approved to be used as a short-term treatment for insomnia (Bouchette et al., 2022). It is a listed medication in the American Geriatrics Society 2019 Updated Criteria for Potentially Inappropriately Medication Use in Older Adults because the elderly can have similar adverse effects as with benzodiazepines, such as delirium, falls, and increased need for hospitalization. In my experience, we gave this medication cautiously to the elderly in the hospital. This was not a first-line of sleep-aids due to the possible adverse effects. I do remember some of our patients “sleepwalking” or becoming delirious after taking this, and then having no recollection of their activities in the morning. Luckily we were there to monitor and intervene, but it could lead to harm if they were left unattended.

Absorption

Zolpidem is rapidly absorbed by the digestive tract and has a short half-life in healthy patients (Bouchette et al., 2022). Elderly population have decreased motility. This population should only receive the lowest dose of 5 mg because their concentrations were higher in RCTs (Bouchette et al., 2022).

Metabolism

This medication is converted into an inactive metabolite. Hepatic impairment, especially in the elderly, will affect the metabolism and dosage of medication given (Bouchette et al., 2022).

Distribution

This drug has vast distribution throughout the body and crosses the blood-brain barrier. Other effects that zolpidem can have is restoring brain function in patients that are in a vegetative state after brain injury (Bouchette et al., 2022).

Excretion

Zolpidem is excreted by the kidneys (Bouchette et al., 2022). Clearance will be decreased in the elderly.

References

Bouchette, D., Akhondi, H., & Quick, J. (2022). Zolpidem. StatPearlshttps://www.ncbi.nlm.nih.gov/books/NBK442008/

The American Geriatrics Society. (2019). American geriatrics society 2019 updated AGS beers criteria for potentially inappropriately medication use in older adults. The American Geriatrics Society67(4), 674-694. https://agingresources.org/wp-content/uploads/2019/08/2019-BEERS-critieria-update.pdf

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