CENTRO ESCOLAR UNIVERSITY COLLEGE OF NURSING PHARMACOLOGY FOR NURSING STUDENTS DIRECTIONS: Answer the different set of cases

and pass it on December 15,

2007 during your class hour in Pharmacology. Use a short bond paper and staple, no folders and should be HAND WRITTEN but for the questionare cases can be on tying modes. President should collect the term paper and alphabeticalize place it on a LONG PLASTIC COVER with cover page on the back with the following information:

CEU COLLEGE OF NURSING PHARMACOLOGY FOR NURSING STUDENTS TERM PAPER PROJECT

SECTION: DATE: TIME: PROFESSOR:

CASE 1:
A 24-year-old G3P3 woman, now 90 minutes after vaginal delivery and having received an injection of methylergonovine, continues to have postpartum bleeding. Her uterus is firmer but still somewhat boggy. Her heart rate remains mildly tachycardic, but her blood pressure has gone up in response to the methylergonovine. Her examination is otherwise unchanged. The physician orders an IM injection of carboprost tromethamine (prostaglandin F 2, or PGF2) 1. 2. 3. 4. What was the problem on the case? Give 2 events What is the therapeutic action of PGF2 in postpartum hemmorrhage? What is the effect of PGFs on vascular smooth muscle? What is the effect of PGFs on bronchial smooth muscle?

CASE 2:
A 16-year-old female comes to the office because of menstrual cramps. She had menarche at age 13. Her menses lasts for 4-5 days, and she has 28-day cycles, for the first 2-3 days of her menses she states that she has very bad cramping. The cramps have been occurred since menarche and seem to have worsened in the past year. They have been so bad at times that she has missed school and has not been able to participate in her after-school sports.

She has been taking acetaminophen and over-the-counter menstrual cramp pills without adequate relief. She has no significant medical history, takes no medications regularly, and not sexually active. Her examination is normal. You asses the problem as primary dysmenorrhea and prescribe naproxen to be used on an as-needed basis. 1. What are the therapeutic effects of nonsteroidal anti-inflammatory drugs (NSAIDs)? 2. What is the mechanism of the anti-inflammatory action of NSAIDs?

CASE 3:
A 48-year-old man comes to your office with a 6-day history of worsening cough productive of green sputum. He has had fever and chills. He complains of pain in the right midback with deep breathing or coughing. Further history reveals that he has smoked one pack of cigarettes a day for 30 years. He has no other significant medical history. On examination, his temperature is 38.1C (100.5F), his respiratory rate is 24 breaths per minute; pulse, 98 beats per minute; blood pressure, 120/75 mmHg; and saturation of oxygen, 96 percent on room air by pulse oximetry. Auscultation of his lungs reveals rales in the right lower-posterior lung field. The remainder of his examination is within the normal limits. A posterior-to-anterior (PA) and lateral chest x-ray show a right lower-lobe in filtrate. A sputum Gram-stain reveals Gram-positive cocci, and subsequent sputum and blood culture results confirm the diagnosis of pneumonia caused by Streptococcus pneumoniae (pneumococcus). The physician ordered and with a combination of amoxicillin and clavulanic acid. 1. What is the mechanism of action of amoxicillin? 2. Draw the structure of bacterial cell wall and show how does this antibiotic attack the microorganism? 3. What is Beta Lactamase? What will be the effects on the drugs bioavailability? 4. What is the mechanism of action of clavulanic acid? What is the significance of this?

CASE 4:
A 58-year-old man presents for the evaluation of a painful rash. He says that for 3 or 4 days he had a sharp, burning pain radiating from his midback around to his left side. He thought he was having a kidney stone. Yesterday he noticed a rash which spread in a distribution like a line in the same area in which he has had the pain. He is on glyburide for type II diabetes, simvastatin for high cholesterol, and lisinopril for hypertension, all of which he has been on for several years. He does have a story of having chickenpox as a child. On examination he has a low-grade fever and otherwise normal vital signs.

His skin exam is remarkable for a rash in a belt like distribution from his spine around his left flank to the midline of the abdomen. The rash consists of erythematous patches with clusters of vesicles. The remainder of his examination is normal. You make the diagnosis of herpes zoster and prescribe a course of acyclovir.

1. What is the mechanism of action of acyclovir? 2. Draw a structure of a Viral Structure and indicate how the drug damages the immunogen? 3. How is acyclovir eliminated from the body? 4. What are your health teachings?

EXAMPLES OF ANTI-VIRAL MECHANISM SUPPLY THE MISSING BOXES

VIRAL LIFE CYCLE 1. 2. 3. 4a. Virus attaches to the cell Virus penetrates the cell Virus uncoats its nucleic acid Synthesis of key viral enzymes such as polymerases(transcription) 4b. Viral nucleic acid is synthesized 5. Late viral structural proteins are synthesized 6 Viral proteins and particles are assembled 7. Viruses are released from the host cell ANTI-VIRAL THERAPY EXAMPLES

REQUIREMENT: (OPTIONAL) LOG-ON TO www.estudy2007.multiply.com (DR.ROXAS SITE) TO SUPPLEMENT YOUR CASE STUDY. CHECK THE BLOG SITE AND THE INTERACTIVE VIDEOS FOR YOU TO SEE AND RELATE ON THE CASES.

Case 5
A 4-year-old boy is brought in by his mother because he keeps scratching a spot on his arm. His mother says that this has been going on several days, and it appears that the spot is growing larger. No one else at home has anything similar. He has not had a fever or any systematic signs of illness. There have been no recent exposures to new foods, medications, lotion, or soaps. He attends pre-school during the day. On examination of his skin you see a circular, nickel-sized ring on his right forearm. It has a red, raised border and central clearing. The remainder of his skin exam and his general physical examination are normal. You diagnose him with tinea corporis (ringworm) and prescribe topical nystatin. What is the mechanism of action of nystatin? Nystatin is similar in structure and function to which other antifungal infection?